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Posttraumatic stress disorder and alcohol misuse among women: effects of ethnic minority stressors

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Abstract

Purpose

The aims of this study were to examine the relationship between adult-onset posttraumatic stress disorder (PTSD) and subsequent alcohol use outcomes (frequent heavy drinking, alcohol abuse, and alcohol dependence) in non-Hispanic white, non-Hispanic black, and Hispanic US women, and whether this relationship was moderated by ethnic minority stressors (discrimination and acculturation).

Methods

The study sample was drawn from two waves of the National Epidemiologic Surveys of Alcohol and Related Conditions, employing time-dependent data to conduct multiple extended Cox regression.

Results

Women with PTSD were over 50 % more likely than those without PTSD to develop alcohol dependence [adjusted hazards ratio (aHR) 1.55; 95 % confidence interval (CI) 1.15, 2.08]. Hispanic and black women were at lower risk of most alcohol outcomes than white women. In race-/ethnic-specific analyses, however, PTSD only predicted alcohol abuse among Hispanic women (aHR 3.02; CI 1.33, 6.84). Higher acculturation was positively associated with all alcohol outcomes among Hispanic women and discrimination was associated with AUD among Hispanic and black women. Acculturation and discrimination modified the effect of PTSD on AUD among Hispanic women: PTSD predicted alcohol dependence among those with low acculturation (aHR 10.2; CI 1.27, 81.80) and alcohol abuse among those without reported discrimination (aHR 6.39; CI 2.76, 16.49).

Conclusions

PTSD may influence the development of hazardous drinking, especially among Hispanic women. The influence of PTSD on alcohol outcomes is most apparent, however, when ethnic minority stressors are not present.

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Acknowledgments

This study was funded by the National Institutes of Health, National Institute of Alcohol Abuse and Alcoholism (NIH/NIAAA) Grant R01 AA 018686. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIH/NIAAA.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA, USA

    Sherry Lipsky & Qian Qiu

  2. Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA

    Mary A. Kernic

  3. Columbia University/New York State Psychiatric Institute, New York, NY, USA

    Deborah S. Hasin

Authors
  1. Sherry Lipsky
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  2. Mary A. Kernic
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  3. Qian Qiu
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  4. Deborah S. Hasin
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Correspondence to Sherry Lipsky.

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Lipsky, S., Kernic, M.A., Qiu, Q. et al. Posttraumatic stress disorder and alcohol misuse among women: effects of ethnic minority stressors. Soc Psychiatry Psychiatr Epidemiol 51, 407–419 (2016). https://doi.org/10.1007/s00127-015-1109-z

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  • DOI: https://doi.org/10.1007/s00127-015-1109-z

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