Posttraumatic stress disorder and alcohol misuse among women: effects of ethnic minority stressors.
OBJECTIVE
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.
Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA, USA. lipsky@u.washington.edu.
Sherry
S
Lipsky
Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.
Mary A
MA
Kernic
Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA, USA.
Qian
Q
Qiu
Columbia University/New York State Psychiatric Institute, New York, NY, USA.
Deborah S
DS
Hasin
D000069:Acculturation; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D000437:Alcoholism / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D063508:Social Discrimination / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
Alcohol misuse; Longitudinal analysis; Posttraumatic stress disorder; Race/ethnicity