Tripp Jessica C, McDevitt-Murphy Meghan E, Avery Megan L, Bracken Katherine L
J Dual Diagn. 2015;11(2):107-17. doi: 10.1080/15504263.2015.1025013.
Posttraumatic stress disorder (PTSD), alcohol use, and alcohol-related consequences have been linked to emotion dysregulation. Sex differences exist in both emotion regulation dimensions and alcohol use patterns. This investigation examined facets of emotion dysregulation as potential mediators of the relationship between PTSD symptoms and alcohol-related consequences and whether differences may exist across sexes.
Participants were 240 college students with a trauma history who reported using alcohol within the past three months and completed measures of PTSD symptoms, emotion dysregulation, alcohol consumption, alcohol-related consequences, and negative affect. The six facets of emotion dysregulation were examined as mediators of the relationship between PTSD symptoms and alcohol-related consequences in the full sample and by sex.
There were differences in sexes on several variables, with women reporting higher PTSD scores and lack of emotional awareness. Men reported significantly more drinks per week in a typical week and a heavy week. There were significant associations between the variables for the full sample, with PTSD showing associations with five facets of emotion dysregulation subscales: impulse control difficulties when upset, difficulties engaging in goal-directed behavior, nonacceptance of emotional responses, lack of emotional clarity, and limited access to emotion regulation strategies. Alcohol-related consequences were associated with four aspects of emotion dysregulation: impulse control difficulties when upset, difficulties engaging in goal-directed behavior, nonacceptance of emotional responses, and limited access to emotion regulation strategies. Two aspects of emotion regulation, impulse control difficulties and difficulties engaging in goal directed behavior, mediated the relationship between PTSD symptoms and alcohol-related consequences in the full sample, even after adjusting for the effects of negative affect. When examined separately by gender, impulse control difficulties remained a mediator for men and difficulties engaging in goal directed behavior for women.
These analyses shed light on processes that may underlie "self-medication" of PTSD symptoms. Gender-specific interventions targeting emotion dysregulation may be effective in reducing alcohol-related consequences in individuals with PTSD. Women may possibly benefit from interventions that focus on difficulties engaging in goal-directed behavior, while men may benefit from interventions that target impulse control difficulties when upset.
创伤后应激障碍（PTSD）、酒精使用及与酒精相关的后果均与情绪失调有关。情绪调节维度和酒精使用模式均存在性别差异。本研究考察了情绪失调的各个方面作为PTSD症状与酒精相关后果之间关系的潜在中介因素，以及性别之间是否存在差异。
研究对象为240名有创伤史的大学生，他们报告在过去三个月内饮酒，并完成了PTSD症状、情绪失调、酒精消费、酒精相关后果及负面影响的测量。在全样本及按性别分组的情况下，考察情绪失调的六个方面作为PTSD症状与酒精相关后果之间关系的中介因素。
在几个变量上存在性别差异，女性报告的PTSD得分更高且缺乏情绪意识。男性报告在典型周和重度饮酒周每周饮酒量显著更多。全样本中各变量之间存在显著关联，PTSD与情绪失调分量表的五个方面相关：心烦时冲动控制困难、难以从事目标导向行为、不接受情绪反应、缺乏情绪清晰度以及情绪调节策略的可及性有限。与酒精相关的后果与情绪失调的四个方面相关：心烦时冲动控制困难、难以从事目标导向行为、不接受情绪反应以及情绪调节策略的可及性有限。情绪调节的两个方面，即心烦时冲动控制困难和难以从事目标导向行为，在全样本中即使在调整负面影响的影响后，仍介导了PTSD症状与酒精相关后果之间的关系。按性别分别考察时，冲动控制困难仍然是男性的中介因素，而难以从事目标导向行为是女性的中介因素。
这些分析揭示了可能是PTSD症状“自我治疗”基础的过程。针对情绪失调的性别特异性干预措施可能有效减少PTSD个体中与酒精相关的后果。女性可能从专注于难以从事目标导向行为的干预措施中受益，而男性可能从针对心烦时冲动控制困难的干预措施中受益。
