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The purpose of this study was to examine the dynamic relationships between daily PTSD symptom severity (PTSS), cognitive and behavioral avoidance coping, and negative drinking consequences following recent injury. Participants consisted of 36 injury survivors (M age  = 34.0, SD = 10.8; 75.0% male; 69.4% White) who completed thrice daily assessments of PTSS, avoidance coping, and negative drinking consequences for 7 days at 6-weeks post-injury. Although hypothesized relationships were not statistically significant in full models with covariates that included alcohol consumption, the confidence intervals associated with focal predictors provided support for predictions. Follow-up analyses without covariates indicated that on occasions when an injury survivor engaged in more avoidance coping and experienced higher levels of PTSS, negative drinking consequences increased by 9% (b = 0.02, SE = 0.01, p  = .006). This interaction was primarily driven by cognitive avoidance coping (b = 0.03, SE = 0.01, p  = .008). Routine screening of avoidance coping, PTSS, and alcohol consumption in the aftermath of recent injury might assist with identifying survivors at risk for negative drinking consequences. Interventions that address cognitive avoidance coping and drinking among survivors experiencing elevated PTSS may help to prevent the development of this comorbidity.

The self-medication hypothesis proposes that individuals experiencing posttraumatic stress disorder (PTSD) symptoms may use alcohol (or other substances) to self-medicate distress, while the mutual maintenance hypothesis proposes that alcohol use also exacerbates or maintains distress. Existing research largely supports the self-medication hypothesis. However, findings are often based upon retrospective reporting of problems and assessment of symptoms anchored to a trauma occurring in the remote past. To improve on these retrospective designs, the current study examined the relationship between daily PTSD symptom severity and alcohol-related outcomes during the early phase of recovery following a traumatic physical injury. Specifically, 36 injury victims reported on PTSD symptom severity, alcohol craving, alcohol consumption, and negative drinking consequences thrice daily (morning, afternoon, night) over 7 days beginning 6 weeks postinjury. Results indicated relationships between PTSD symptom severity and alcohol craving/negative consequences when these experiences were assessed concurrently within the same signal (particularly during the nighttime assessments). Prospective models found that nighttime PTSD symptom severity was related to negative drinking consequences occurring the following morning, even after controlling for consumption level, suggesting a more general behavioral regulation problem. Results were less supportive of the mutual maintenance hypothesis. Collectively, these results suggest that health interventions targeting PTSD symptom severity in recent injury victims-particularly when delivered at night-may be able to prevent problematic alcohol use. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)