Posttraumatic stress disorder and alcohol dependence in young women.
OBJECTIVE
The aim of the current study is to characterize the relationship between posttraumatic stress disorder (PTSD) and alcohol dependence (AD) in women, distinguishing PTSD-specific influences on AD from the contribution of co-occurring psychiatric conditions and from the influences of trauma more generally.


METHODS
Trauma histories and DSM-IV lifetime diagnoses, including PTSD and AD, were obtained via telephone interview from 3,768 female twins. Based on PTSD status and trauma history, participants were categorized as no trauma (43.7%), trauma without PTSD (52.6%), or trauma with PTSD (3.7%). Cox proportional hazards regression analyses were conducted using trauma/PTSD status to predict AD, first adjusting only for ethnicity and parental problem drinking, then including conduct disorder, major depressive disorder, regular smoking, and cannabis abuse.


RESULTS
Before accounting for psychiatric covariates, elevated rates of AD were evident in both trauma-exposed groups, but those with PTSD were at significantly greater risk for AD than those without PTSD. This distinction was no longer statistically significant when psychiatric covariates were included in the model, but both trauma-exposed groups continued to show elevated odds of developing AD compared with the no trauma group.


CONCLUSIONS
The elevated rates of AD in women who have experienced trauma are not accounted for in full by psychiatric conditions that commonly co-occur with AD and trauma exposure. The greater likelihood of developing AD in the subset of trauma-exposed individuals who develop PTSD may reflect higher levels of distress and/ or higher rates of psychopathology associated with traumas that lead to PTSD rather than PTSD-specific influences.
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA. sartorc@psychiatry.wustl.edu
Carolyn E
CE
Sartor
Vivia V
VV
McCutcheon
Nicole E
NE
Pommer
Elliot C
EC
Nelson
Alexis E
AE
Duncan
Mary
M
Waldron
Kathleen K
KK
Bucholz
Pamela A F
PA
Madden
Andrew C
AC
Heath
D000293:Adolescent; D000367:Age Factors; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D004200:Diseases in Twins / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult