Skip to main content
ABCT 2025 59th Annual Convention Main banner
Psychology Tools Ad
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Recorded Session
Recorded Session
Ticketed Session
Ticketed Session
ViewAttendees 2

Individual Oral Paper

Trauma and Stressor Related Disorders and Disasters

Trauma and PTSD: Risk Factors, Comorbidities, and Population Specific PTSD Dynamics

2 - (IOP 5) Hybrid PTSD Factor Associations with Alcohol and Substance Use, Their Consequences, and Mediation by Self-medication Motives

Friday, November 21, 2025
10:15 AM - 10:30 AM CST
Location: Celestin G, Level 3
Keywords: PTSD (Posttraumatic Stress Disorder), Alcohol, Substance Abuse
Recommended Readings: Claycomb Erwin, M., Charak, R., Durham, T. A., Armour, C., Lv, X., Southwick, S. M., Elhai, J. D., & Pietrzak, R. H. (2017). The 7-factor hybrid model of DSM-5 PTSD symptoms and alcohol consumption and consequences in a national sample of trauma-exposed veterans. Journal of Anxiety Disorders, 51, 14–21. https://doi.org/10.1016/j.janxdis.2017.08.001,   Fischer, I. C., Bennett, M. E., Pietrzak, R. H., Kok, B. C., & Roche, D. J. O. (2022). Examining the associations between PTSD symptom clusters and alcohol-related problems in a sample of low-SES treatment-seeking Black/African American adults. Journal of Psychiatric Research, 154, 261–267. https://doi.org/10.1016/j.jpsychires.2022.07.060,   Palmisano, A. N., Norman, S. B., Panza, K. E., Petrakis, I. L., & Pietrzak, R. H. (2022). PTSD symptom heterogeneity and alcohol-related outcomes in U.S. military veterans: Indirect associations with coping strategies. Journal of Anxiety Disorders, 85, 102496. https://doi.org/10.1016/j.janxdis.2021.102496,   ,  
The self-medication hypothesis is a well-supported model for understanding the high rates of co-occurrence between PTSD and alcohol/substance use disorders. While past research has evaluated the correspondence between the seven “hybrid” model PTSD factors and alcohol use, the current study expands our investigation beyond alcohol use to include non-alcohol substances, as well as their correlates (e.g., craving) and consequences (e.g., functional problems). Additionally, we examine the role of coping-motivated use in the relationship between PTSD symptom severity and alcohol/substance use for more direct evidence of self-medication versus other motives for use.

Trauma-exposed individuals (N = 462) completed online PTSD symptom (PCL-5) and alcohol/substance use (NIDA-Modified ASSIST) questionnaires. Zero-inflated Poisson regression examined relationships between hybrid PTSD symptom factor scores and alcohol/cannabis use, while logistic regression was used for cocaine, prescription stimulants, sedatives/sleeping pills, hallucinogens, and prescription opioids. Mediation analyses tested whether coping motives for depression and PTSD mediate the association between PTSD symptom factors and alcohol/cannabis use.
Results indicated that elevations in certain PTSD factors (e.g., externalizing behaviors) are more strongly associated with risk for recent use and consequences across substances, while others indicated decreased risk (e.g., anhedonia). Two PTSD factors (negative affect and dysphoric arousal) showed differential relationships with substance use depending on whether that substance was used. For example, negative affect was associated with a lower probability of cannabis use overall (pd = 95.25%), but associated with greater cannabis use frequency for participants who reported recent cannabis use (pd = 97.15%). All PTSD factor-to-alcohol/cannabis use relationships were mediated by coping-motivated use to manage PTSD and depression symptoms.

These findings replicate and extend past research to highlight the benefits of examining the unique risks conferred by specific hybrid PTSD symptom factors and the patterns of alcohol and non-alcohol substances used to cope with them.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. List the seven hybrid PTSD factors and describe the general patterns of how they relate to recent alcohol/non-alcohol substance use.