Trauma exposure, posttraumatic stress disorder and problem drinking in sexual assault survivors.
OBJECTIVE
Sexual assault history is associated with higher risk of problem drinking in women, yet little is known about mechanisms linking trauma histories to women's problem drinking. This study examined how trauma histories, alcohol-related cognitive mediators and posttraumatic stress disorder (PTSD) relate to past-year problem drinking in adult female sexual assault survivors.


METHODS
Data from self-report questionnaires completed by a large, diverse sample (N = 865) of community-residing women who had experienced adult sexual assault were analyzed. Structural equation modeling was used to test a theoretical model examining the relationship between trauma exposure, alcohol-related cognitive mediators, PTSD symptoms and past-year problem drinking.


RESULTS
These analyses suggested that trauma exposure, drinking to cope with distress and tension-reduction expectancies are the most consistent factors associated with problem drinking, whereas PTSD symptoms are not. Drinking to cope and tension-reduction expectancies were both related to greater PTSD symptoms, consistent with self-medication theory.


CONCLUSIONS
These results suggest that trauma histories, drinking to cope and tension reduction may be important risk factors distinguishing sexually assaulted women who develop problem drinking from those who do not. Screening women for trauma histories even within samples of victims and assessment of women's ways of coping and beliefs about alcohol's effects may help to identify those at greater risk for problem drinking.
Ullman
Sarah E
SE
Department of Criminal Justice, University of Illinois at Chicago, Illinois 60607, USA. seullman@uic.edu
Filipas
Henrietta H
HH
Townsend
Stephanie M
SM
Starzynski
Laura L
LL
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology*; D002641:Chicago; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008960:Models, Psychological; D011902:Rape / Q000523:psychology / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012718:Set, Psychology; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology