Category: Addictive Behaviors

Symposium

Comorbid Depression, Posttraumatic Stress, and Alcohol Misuse: The Transdiagnostic Role of Distress Tolerance

Friday, November 17
1:45 PM - 3:15 PM
Location: Sapphire 410, Level 4, Sapphire Level

Keywords: Comorbidity | Distress Tolerance | Mediation / Mediators
Presentation Type: Symposium

Heavy alcohol use is common among young adult veterans, and is commonly comorbid with depression and posttraumatic stress disorder (PTSD). Research in civilian populations has suggested that distress tolerance – defined as the capacity to withstand negative psychological states – may be a transdiagonstic factor that accounts for the development of these mental health disorders, and may also explain the comorbidity among problem drinking, depression, and PTSD. However, the role of distress tolerance has not been evaluated in a veteran population. This cross-sectional study recruited 783 young adult veterans (age 19-34), who completed self-report measures of alcohol use (Alcohol Use Disorders Identification Test; AUDIT), depression (Patient Health Questionnaire-8; PHQ), PTSD (PTSD Checklist-5; PCL), and distress tolerance (Distress Tolerance Scale). Most participants were male (83%), non-Hispanic (90%), and white (85%), with mean age of 28.88 years (SD = 3.39). Most of the sample was Army and Marine Corps veterans. The PROCESS macro was used to examine distress tolerance as a mediator of the association between (1) probable PTSD (PCL ≥ 33), (2) probable depression (PHQ ≥ 10), and (3) comorbid probable PTSD and depression with alcohol misuse. Moderated mediation models were used to examine gender as a moderator. Results demonstrated that distress tolerance significantly mediated the relationship between each of these mental health concerns and alcohol misuse. Evidence of moderated mediation was observed for probable PTSD and probable comorbid PTSD and depression, with the indirect effect stronger among males. This study is among the first to provide evidence that poor distress tolerance may be a transdiagnostic factor accounting for the comorbidity between two devastating mental health conditions and alcohol problems in a high-risk population – postdeployment veterans. Moreover, given the increasing focus on gender-responsive treatments for veteran populations, understanding the role of gender in the etiology of these concerns will ensure that treatments are maximally effective for both male and female veterans.

Stephanie Brooks Holliday

RAND Corporation

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Comorbid Depression, Posttraumatic Stress, and Alcohol Misuse: The Transdiagnostic Role of Distress Tolerance



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