title: Examination of the dynamic interplay between posttraumatic stress symptoms and alcohol misuse among combat-exposed Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) Veterans.
abstract: BACKGROUND
  Although alcohol misuse co-occurs with PTSD symptoms at a strikingly high rate (i.e., nearly 52% of men and 28% of women with PTSD also meet diagnostic criteria for an Alcohol Use Disorder), the functional associations between these symptom types remain unclear.
  
  
  METHODS
  The current study sought to clarify the nature of posttraumatic stress-alcohol misuse relations by employing a prospective longitudinal methodology-the latent difference score approach-to examine dynamic change in posttraumatic stress symptoms and alcohol misuse among 478 combat-exposed Veterans completing a longitudinal survey of post-deployment mental and physical health. This study builds on the existing literature, as most prior research has been limited to cross-sectional studies and has not explored prospective relations between specific PTSD symptom clusters and alcohol misuse.
  
  
  RESULTS
  Consistent with the self-medication model, results indicated that PTSD symptoms demonstrate a prospective and proximal association with alcohol misuse during the assessment period; however, alcohol misuse did not appear to be a unique contributor to overall PTSD symptom exacerbation over time. Examination of individual PTSD symptom clusters revealed that more severe symptoms of intrusion and numbing, but not avoidance and hyperarousal, predicted greater alcohol misuse at subsequent time intervals.
  
  
  CONCLUSIONS
  The constructs examined within this investigation relied on self-report data; diagnostic criteria for PTSD and/or Alcohol Use Disorders were not assessed. Future work may benefit from replicating these findings in clinical populations formally diagnosed with PTSD via clinician-administered structured interviews.
  
  
  CONCLUSIONS
  Findings underscore the importance of addressing PTSD symptoms in the context of alcohol treatment to facilitate improved drinking outcomes.
authors.affiliation: National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States; Department of Psychiatry, Boston University School of Medicine, United States. Electronic address: kirstenjlangdon@gmail.com.
authors.forename: Kirsten J
authors.initials: KJ
authors.lastname: Langdon
authors.affiliation: National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States.
authors.forename: Annie B
authors.initials: AB
authors.lastname: Fox
authors.affiliation: National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States; Department of Psychiatry, Boston University School of Medicine, United States; Department of Psychology, Boston University School of Medicine, United States.
authors.forename: Lynda A
authors.initials: LA
authors.lastname: King
authors.affiliation: Department of Psychiatry, Boston University School of Medicine, United States; Department of Psychology, Boston University School of Medicine, United States; National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, United States.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: King
authors.affiliation: Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, United States; Department of Health Policy and Management, Boston University School of Public Health, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Eisen
authors.affiliation: National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States; Department of Psychiatry, Boston University School of Medicine, United States.
authors.forename: Dawne
authors.initials: D
authors.lastname: Vogt
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000428:Alcohol Drinking / Q000453:epidemiology; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Alcohol; Combat; Posttraumatic stress disorder; Structural equation modeling; Trauma