Posttraumatic stress disorder symptoms and risky behaviors among trauma-exposed inpatients with substance dependence: The influence of negative and positive urgency.
BACKGROUND
Posttraumatic stress disorder (PTSD) among inpatients with substance use disorders (SUDs) is associated with heightened engagement in a variety of risky, self-destructive, and health-compromising behaviors (e.g., risky sexual behavior, aggression). Extant research provides support for the role of emotion dysregulation in the PTSD-risky behavior relation among inpatients with SUD; however, this research has been limited by a focus on emotion dysregulation involving negative (versus positive) emotions. The goal of the current study was to extend past research on the PTSD-risky behavior relation by examining the potential mediating roles of negative and positive urgency (two domains of emotion dysregulation defined by the tendency to engage in risky behavior in the context of negative and positive emotions, respectively).


METHODS
Participants were 158 trauma-exposed inpatients with (n=91) and without (n=67) lifetime PTSD consecutively admitted to a residential SUD treatment facility (M age=34.34; 59.5% White, 50.6% female). Patients were administered diagnostic interviews and completed self-report questionnaires.


RESULTS
Significant positive associations were found among lifetime PTSD symptoms, negative and positive urgency, and risky behaviors. Moreover, findings revealed significant indirect effects of lifetime PTSD symptoms on risky behaviors through the pathways of both negative and positive urgency.


CONCLUSIONS
Results provide initial support for the mediating roles of both negative and positive urgency in the PTSD-risky behavior relation, highlighting the potential utility of teaching trauma-exposed inpatients with PTSD-SUD skills for tolerating negative and positive emotional states without engaging in maladaptive behaviors.
Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT 06511, USA. Electronic address: nhweiss7@gmail.com.
Nicole H
NH
Weiss
University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. Electronic address: mtull@umc.edu.
Matthew T
MT
Tull
Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT 06511, USA. Electronic address: tami.sullivan@yale.edu.
Tami P
TP
Sullivan
University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA 01003-9271, USA. Electronic address: katiedg@gmail.com.
Katherine L
KL
Dixon-Gordon
University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. Electronic address: klgratz@aol.com.
Kim L
KL
Gratz
D000293:Adolescent; D000328:Adult; D004644:Emotions; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000523:psychology*; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology*; D055815:Young Adult
Emotion dysregulation; Negative urgency; Positive urgency; Posttraumatic stress disorder; Risky behaviors; Substance use disorder