Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Psychology, Clinical-Community

Date of Defense

4-26-2022

Graduate Advisor

Steven Bruce, PhD

Committee

Ann Steffen, PhD, ABPP

Ryan Carpenter, PhD

Rachel Winograd, PhD

Abstract

Despite a high comorbidity rate between trauma/PTSD and problematic alcohol/substance use, there is only a small body of work investigating moderators and mediators in this relationship. Few studies have examined the role of self-regulation, composed of coping and emotion regulation, in the context of PTSD and problematic substance use. Prior work has generally measured self-regulation categorically, with strategies labeled as maladaptive or adaptive, and therefore failing to account for the adaptiveness of the strategy in particular contexts. The present study is the only one to date to examine self-regulation flexibility in the relationship between posttraumatic symptoms (PTSS) and problematic alcohol/substance use. The study also examines the role of various trauma characteristics, including total trauma exposure and trauma type, in the context of PTSS, problematic alcohol/substance use, and self-regulation flexibility. Further, differences in individuals endorsing polysubstance use and monosubstance use with respect to PTSS and self-regulation flexibility is explored. The study involved 359 trauma-exposed participants who completed several self-report measures on trauma exposure, trauma characteristics, PTSS, self-regulation flexibility, and problematic alcohol/substance use. PTSS was related to problematic alcohol and substance use, with greater exposure to trauma and presence of childhood trauma relating to greater PTSS. Results also found that individuals engaging in polysubstance use, compared to monosubstance use, experienced a greater number of traumas and PTSS. Higher trauma exposure and presence of childhood trauma were related to lower levels of coping flexibility, although PTSS was not related to coping flexibility. PTSS was unexpectedly related to greater emotion regulation flexibility. Although findings did not support a mediation role of self-regulation flexibility in the relationship between PTSS and problematic alcohol/substance use, the study supports continued development of the self-regulation flexibility construct as well as future studies assessing for a meditational role with different methodology.

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