Study Finds Long-Lasting PTSD Symptoms Increase Drinking Risk in Youth

By Michael De Bellis, MD, MPH

It’s not uncommon for adolescents to experience a traumatic event and/or witnessing or learning about traumatic events that happened to close friends or relatives. These exposures can lead to distress and long-lasting posttraumatic stress disorder (PTSD) symptoms such as upsetting thoughts of the trauma, increased arousal, sleep problems, moodiness, feelings of numbness and avoidance of reminders of the trauma. 

Many research studies have shown that teenagers who have these experiences are more likely to engage in problem drinking, possibly as a way to minimize their PTSD symptoms. But since most previous studies have collected traumatic event and drinking data at the same time (e.g., “cross-sectional” studies), it has been unclear whether the traumatic event itself, or the posttraumatic stress symptoms that occurred after the traumatic event, caused problematic drinking in teenagers. 

Professor Michael D. De Bellis, MD, MPH, director of the Healthy Childhood Brain Development Developmental Traumatology Research Program in the Department of Psychiatry & Behavioral Sciences, recently led a study to explore this question.

The study data came from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) at Duke University Medical Center. NCANDA is a unique national representative study of a diverse sample of 831 youth, ages 12-21 years, recruited across five U.S. sites (Duke University Medical Center, University of Pittsburgh Medical Center, Oregon Health & Science University, University of California, San Diego and SRI International). 

De Bellis is one of the principal investigators of the NCANDA study, which uses a longitudinal prospective design to examine the psychological, environmental and neurobiological predictors and consequences of adolescent drinking on brain development by collecting data on the NCANDA sample each year. 

De Bellis and his team examined if the number of traumatic events a youth experienced, or the presence of PTSD symptoms reported after the traumatic event in the first year of the study’s data collection, were associated with problematic binge drinking in the later years of the study. Binge drinking is defined as four or more drinks in a single drinking event.

The researchers found that the participants with chronic PTSD symptoms in the first year of the study were more likely to transition to moderate to heavy binge drinking in study follow-up years two to four, compared to the participants who reported no traumas at baseline. 

The baseline number of traumatic events reported at study entry did not predict transitions to moderate to heavy binge drinking in study follow-up years two to four. 

This study was the first to investigate the effects of experiencing traumatic events versus having chronic posttraumatic stress symptoms that occurred after the traumatic event on later problematic drinking in teenagers. 

The findings suggest that having chronic posttraumatic stress symptoms in response to traumatic events increases the risk for progression to moderate and heavy alcohol use in teenagers and young adults. 

It’s possible that early treatment of chronic posttraumatic stress symptoms may stop this progression—this is the next logical step for this line of research. 

Read the full article in Current Addiction Reports.

PTSD treatment resources can be found on the National Child Traumatic Stress Center (NCTSN) website. The NCTSN is funded by the Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Department of Health and Human Services, and is jointly coordinated by UCLA and Duke University.

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