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OBJECTIVE Affective and emotional dysregulation are consistently linked to greater alcohol use and related consequences, including risky sexual behavior. Moreover, these associations are even stronger among women with experiences of sexual assault. The current study tested affect, alexithymia, positive urgency, and negative urgency as predictors of alcohol use, alcohol-related consequences, and risky sexual behavior and the moderating impact of rape history on these associations among a sample of college women. METHOD Participants were 1,005 college women between the ages of 18 and 25. Approximately 20% of the sample (n = 204) reported a history of rape since age 14. RESULTS Positive and negative urgency statistically mediated the associations between negative affect and alexithymia and the alcohol and risky sex outcomes. Positive urgency was directly associated with alcohol use, while negative urgency was directly associated with alcohol-related consequences. Moreover, rape history moderated these associations, indicating that positive affect may be an important protective factor among women who have experienced rape. CONCLUSIONS The current study identified important unique risk and protective pathways that may increase or reduce women's risk for alcohol-related consequences and risky sexual behavior. Importantly, these pathways are comprised of constructs that are malleable and modifiable and can be targeted and changed through intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

According to the I3 model, intimate partner violence (IPV) results from an interaction of instigating, impelling, and inhibiting factors. Attachment insecurity is a well-established risk factor for IPV perpetration, but few studies have focused on its role as an impellor within an I3 framework. The current study investigated the independent and interactive effects of attachment insecurity (in impelling factor) and hazardous alcohol use (a disinhibiting factor) on IPV perpetration. It was hypothesized that hazardous alcohol use would moderate the relationship between attachment insecurity and IPV perpetration, such that this relationship would be stronger at higher levels of hazardous alcohol use. Couples (N = 133 dyads) ages 18–40 who had been involved in a committed inti-mate partner relationship for at least 90 days and had consumed alcohol within the past 90 days were recruited online through Amazon’s Mechanical Turk and a university recruitment system. Structural equation models were estimated using the Actor-Partner Interdependence Model to evaluate actor and partner effects of each risk factor on IPV perpetration. The hypothesized interaction was not significant; however, both hazardous alcohol use and attachment insecurity uniquely predicted different forms of IPV. Results suggest that impelling and inhibiting processes may differentially influence psychological aggression and physical assault, providing further support for varying thresholds for perpetration as posited by the I3 model. Partner effects for both predictors were observed, such that attachment insecurity and hazardous alcohol use of one partner predicted IPV perpetrated by the other partner. These findings also highlight the importance of considering dyadic processes when conceptualizing the etiological and perpetuating factors of IPV.

BackgroundCurrent clinical assessments of Posttraumatic stress disorder (PTSD) rely solely on subjective symptoms and experiences reported by the patient, rather than objective biomarkers of the illness. Recent advances in data-driven computational approaches have been helpful in devising tools to objectively diagnose psychiatric disorders. Here we aimed to classify individuals with PTSD versus controls using heterogeneous brain datasets from the ENIGMA-PGC PTSD Working group.MethodsWe analyzed brain MRI data from 3,527 structural-MRI; 2,502 resting state-fMRI; and 1,953 diffusion-MRI. First, we identified the brain features that best distinguish individuals with PTSD from controls (TEHC and HC) using traditional machine learning methods. Second, we assessed the utility of the denoising variational autoencoder (DVAE) and evaluated its classification performance. Third, we assessed the generalizability and reproducibility of both models using leave-one-site-out cross-validation procedure for each modality.ResultsWe found lower performance in classifying PTSD vs. controls with data from over 20 sites (60% test AUC for s-MRI, 59% for rs-fMRI and 56% for d-MRI), as compared to other studies run on single-site data. The performance increased when classifying PTSD from HC without trauma history across all three modalities (75% AUC). The classification performance remained intact when applying the DVAE framework, which reduced the number of features. Finally, we found that the DVAE framework achieved better generalization to unseen datasets compared with the traditional machine learning frameworks, albeit performance was slightly above chance.ConclusionOur findings highlight the promise offered by machine learning methods for the diagnosis of patients with PTSD. The utility of brain biomarkers across three MRI modalities and the contribution of DVAE models for improving generalizability offers new insights into neural mechanisms involved in PTSD.Significance⍰Classifying PTSD from trauma-unexposed healthy controls (HC) using three imaging modalities performed well (∼75% AUC), but performance suffered markedly when classifying PTSD from trauma-exposed healthy controls (TEHC) using three imaging modalities (∼60% AUC).⍰Using deep learning for feature reduction (denoising variational auto-encoder; DVAE) dramatically reduced the number of features with no concomitant performance degradation.⍰Utilizing denoising variational autoencoder (DVAE) models improves generalizability across heterogeneous multi-site data compared with the traditional machine learning frameworks

BackgroundThe cerebellum critically contributes to higher-order cognitive and emotional functions such fear learning and memory. Prior research on cerebellar volume in PTSD is scant and has neglected neuroanatomical subdivisions of the cerebellum that differentially map on to motor, cognitive, and affective functions.MethodsWe quantified cerebellar lobule volumes using structural magnetic resonance imaging in 4,215 adults (PTSD n= 1640; Control n=2575) across 40 sites from the from the ENIGMA-PGC PTSD working group. Using a new state-of-the-art deep-learning based approach for automatic cerebellar parcellation, we obtained volumetric estimates for the total cerebellum and 28 subregions. Linear mixed effects models controlling for age, gender, intracranial volume, and site were used to compare cerebellum total and subregional volume in PTSD compared to healthy controls. The Benjamini-Hochberg procedure was used to control the false discovery rate (p-FDR< .05).ResultsPTSD was associated with significant grey and white matter reductions of the cerebellum. Compared to controls, people with PTSD demonstrated smaller total cerebellum volume. In addition, people with PTSD showed reduced volume in subregions primarily within the posterior lobe (lobule VIIB, crus II), but also the vermis (VI, VIII), flocculonodular lobe (lobule X), and cerebellar white matter (allp-FDR< 0.05). Effects of PTSD on volume were consistent, and generally more robust, when examining symptom severity rather than diagnostic status.ConclusionsThese findings implicate regionally specific cerebellar volumetric differences in the pathophysiology of PTSD. The cerebellum appears to play an important role in high-order cognitive and emotional processes, far beyond its historical association with vestibulomotor function. Further examination of the cerebellum in trauma-related psychopathology will help to clarify how cerebellar structure and function may disrupt cognitive and affective processes at the center of translational models for PTSD.

Reinforcement Sensitivity Theory (RST) provides a theoretical foundation associated with various approach and avoidance behaviors and individual personality differences. Sensitivity to reward and punishment, two neural systems within the RST have been significantly associated with bingeing and purging behaviors. However, inconsistent findings are observed and specific factors mediating these relationships are not well understood. Deficits in emotion regulation may account for these relationships, as both negative urgency and distress tolerance have been independently associated with bulimia behaviors. Thus, this is an area that requires further investigation. The current study utilized various self-report inventories, including the Eating Disorder Inventory-3rd Edition to measure bulimia symptoms, as well as measures of negative affect, sensitivity to reward and punishment, distress tolerance, and negative urgency. These measures were used to assess whether distress tolerance and negative urgency mediated associations between sensitivity to reward and punishment and bulimia symptoms in a community sample of 394 young adults ranging from the ages of 18 to 25. As expected, sensitivity to reward and punishment were significantly associated with decreased distress tolerance. Distress tolerance was also directly associated with greater negative urgency, which was significantly associated with increased bulimia symptoms. Consistent with hypotheses, indirect associations between sensitivity to reward and sensitivity to punishment to bulimia symptoms via distress tolerance and negative urgency were observed, controlling for gender and negative affect. Results contribute to understanding specific contributions of risk factors within the relationship of sensitivity to reward and punishment and bulimia symptoms, measured by the EDI-3. Novel to existing literature, results indicate that reinforcement sensitivity significantly contributes to emotion regulation deficits. Thus, these findings may have important implications for understanding the development and treatment of bulimia symptoms. Level V, based on descriptive, cross-sectional data.

Background: Posttraumatic stress disorder (PTSD) is accompanied by disrupted cortical neuroanatomy. We investigated alteration in covariance of structural networks associated with PTSD in regions that demonstrate the case-control differences in cortical thickness (CT) and surface area (SA). Methods: Neuroimaging and clinical data were aggregated from 29 research sites in >1300 PTSD cases and >2000 trauma-exposed control subjects (ages 6.2–85.2 years) by the ENIGMA-PGC (Enhancing Neuro Imaging Genetics through Meta Analysis–Psychiatric Genomics Consortium) PTSD working group. Cortical regions in the network were rank ordered by the effect size of PTSD-related cortical differences in CT and SA. The top-n (n = 2–148) regions with the largest effect size for PTSD > non-PTSD formed hypertrophic networks, the largest effect size for PTSD < non-PTSD formed atrophic networks, and the smallest effect size of between-group differences formed stable networks. The mean structural covariance (SC) of a given n-region network was the average of all positive pairwise correlations and was compared with the mean SC of 5000 randomly generated n-region networks. Results: Patients with PTSD, relative to non-PTSD control subjects, exhibited lower mean SC in CT-based and SA-based atrophic networks. Comorbid depression, sex, and age modulated covariance differences of PTSD-related structural networks. Conclusions: Covariance of structural networks based on CT and cortical SA are affected by PTSD and further modulated by comorbid depression, sex, and age. The SC networks that are perturbed in PTSD comport with converging evidence from resting-state functional connectivity networks and networks affected by inflammatory processes and stress hormones in PTSD.

The current study aimed to examine the mediating role of early maladaptive schemas (EMSs) in the associations between types of childhood maltreatment and adulthood proneness to shame and guilt. A path analysis was tested to examine the direct and indirect effects of neglect, sexual abuse, and punishment on shame and guilt via EMSs of incompetence, failure, social isolation, emotional inhibition, and unrelenting standards, over and above gender. Data were collected from 415 university students (73% female) aged 18–26. Participants completed self-report measures of childhood maltreatment, EMSs, and shame and guilt. Neglect was indirectly associated with increased shame-withdraw via incompetence. Sexual abuse was directly associated with decreased guilt-repair. Punishment was indirectly associated with increased guilt-repair via unrelenting standards. Results identified different developmental pathways of proneness to shame and guilt and supported the mediating role of EMSs of incompetence and unrelenting standards. Findings provide support for treatments of shame that target childhood neglect and maladaptive schemas.

Studies of posttraumatic stress disorder (PTSD) report volume abnormalities in multiple regions of the cerebral cortex. However, findings for many regions, particularly regions outside commonly studied emotion-related prefrontal, insular, and limbic regions, are inconsistent and tentative. Also, few studies address the possibility that PTSD abnormalities may be confounded by comorbid depression. A mega-analysis investigating all cortical regions in a large sample of PTSD and control subjects can potentially provide new insight into these issues. Given this perspective, our group aggregated regional volumes data of 68 cortical regions across both hemispheres from 1379 PTSD patients to 2192 controls without PTSD after data were processed by 32 international laboratories using ENIGMA standardized procedures. We examined whether regional cortical volumes were different in PTSD vs. controls, were associated with posttraumatic stress symptom (PTSS) severity, or were affected by comorbid depression. Volumes of left and right lateral orbitofrontal gyri (LOFG), left superior temporal gyrus, and right insular, lingual and superior parietal gyri were significantly smaller, on average, in PTSD patients than controls (standardized coefficients = −0.111 to −0.068, FDR corrected P values < 0.039) and were significantly negatively correlated with PTSS severity. After adjusting for depression symptoms, the PTSD findings in left and right LOFG remained significant. These findings indicate that cortical volumes in PTSD patients are smaller in prefrontal regulatory regions, as well as in broader emotion and sensory processing cortical regions.

We tested within- and between-person effects of posttraumatic stress disorder (PTSD) symptoms on conduct problems and alcohol intoxication via self-control demands using multilevel structural equation modeling in a longitudinal burst-design study of 251 U.S. veterans who participated in the recent wars in Iraq and Afghanistan. We theorized that experiencing PTSD symptoms engenders efforts to regulate mood, control thoughts, and inhibit or control behavior that is taxing to the individual (i.e., it places demands on self-control) and hypothesized that this process results in subsequent deficits in regulatory control that manifest in heightened intoxication and conduct problems associated with PTSD. At the within-person level, daytime PTSD symptoms, IRR = 1.09, and self-control demands, IRR = 1.12, exhibited within-person associations with nighttime conduct problems over and above nighttime intoxication. Consistent with our hypothesis, daytime increases in self-control demands mediated the associations between daytime PTSD symptoms and subsequent nighttime conduct problems. The indirect effect between daytime PTSD symptoms and nighttime intoxication via self-control demands was nonsignificant. At the between-person level, self-control demands mediated the associations between PTSD symptoms and conduct problems; however, the expected between-person associations with intoxication were nonsignificant. Drinking behavior is related to but cannot fully account for various difficulties in psychosocial functioning associated with PTSD. The present results suggest that dysregulated behavior may, ironically, stem from individuals' concerted efforts to control and manage overwhelming symptoms. Self-control demands may be a common factor that accounts for a broad range of functional impairments associated with PTSD.

This study tested a multiple group path model in a sample of young adults (n = 402; 233 university participant pool/169 Amazon MTurk) linking positive and negative affect to alcohol consumption and problems via enhancement and coping motives, respectively. Motivational models of alcohol use suggest that individuals drink in order to alleviate negative affective states or to enhance positive moods or feelings. Deficits in modulating attention toward emotional experience (i.e., involuntary attention to emotion [IAE]); and poor distress tolerance may contribute to maladaptive patterns of substance use (i.e., negative reinforcement). As negative affect increases, those with deficits in the ability to efficiently attend to emotions as well as the inability to withstand distress may seek more external means of regulating unwanted or intrusive emotional experiences via alcohol. It was hypothesized that involuntarily attending to one's emotions would contribute to negative reinforcement drinking and problems. Coping motives were directly associated with alcohol-related problems, while enhancement motives were directly associated with problems both directly and indirectly via alcohol consumption. The hypothesized interaction between negative affect and IAE to coping motives was conditional upon levels of distress tolerance, with the moderating effect of involuntary attention being significant at high but not low levels of distress tolerance. Distress tolerance exhibited direct, inverse associations with alcohol-related problems. This pathway was significant over and above the direct effects of both coping motives and alcohol consumption. This suggests that while tolerance for emotional distress may reduce negative reinforcement drinking, it also fosters adaptive regulation when intoxicated. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The current study aims to investigate the indirect associations between experiential avoidance (EA) and burnout, wellbeing, and productivity loss (PL) via the mediating role of positive and negative emotions among police officers.Data were collected on 187 officers (84% male) aged 21-64 years between 2019 and 2020. Participants completed online self-report measures.EA was indirectly associated with burnout via positive and negative affect. EA was indirectly associated with wellbeing through positive affect, positive affect and burnout, and negative affect and burnout. Finally, EA was indirectly associated with PL via positive affect and burnout, and negative affect and burnout.Results provide support for the role of EA in officers' wellbeing and job performance via increasing negative affect and decreasing positive affect. This highlights the importance of interventions, such as acceptance and commitment therapy that target acceptance and psychological flexibility.

First responders are routinely and regularly exposed to traumatic events that can clinically manifest with a symptom constellation of posttraumatic stress disorder (PTSD), generalized anxiety, depression, and suicidality.We used network analysis to examine baseline data from treatment seeking first responders (n = 308) to examine the interrelatedness of those constructs, including a measure of resilience. We estimated two models: a regularized partial correlation network and a Bayesian Directed Acyclic Graph (DAG).The models reveal converging evidence highlighting the central role of negative alterations in cognitions and mood PTSD cluster along with affective depression. These nodes did not significantly differ, though they were among the strongest in the partial correlation network and shared the most variance with the other nodes. The DAG results suggested that the negative alterations in cognitions and mood PTSD cluster predicted downstream constructs of affective depression; intrusion, hyperarousal, and avoidance PTSD clusters; and resilience. Only resilience and affective depression exhibited direct effects on suicidality. Both somatic depression and suicidality were endogenous endpoints in the DAG. Resilience exhibited an inverse path to suicide. However, resilience was relatively independent of the other constructs in the models and the DAG suggested that it was a consequence of PTSD related distress.The data is cross-sectional in nature that should be followed up in longitudinal studies.Findings are discussed in respect to the role of distress and emotional dysregulation as common factors underlying a broad range of internalizing problems.

In the acquired preparedness model of risk, alcohol expectancies mediate the association between personality and alcohol problems. In the current study, we tested the associations between temperament (i.e., effortful control and reactivity) and temperament-congruent expectancies of distal and proximal effects. It was hypothesized that effortful control would be inversely associated with drinking and problems and that these effects would be mediated through consequence expectancies. Alternatively, it was hypothesized that reactivity would be positively associated with drinking and problems and that these effects would be mediated by expectancies of immediate stimulation and attenuated sedation. This article presents data from a multiple group analyses with 483 young adults (76% female) from a university in the Midwest (n = 209) and Amazon's Mechanical Turk (n = 274). The hypotheses were partially supported. Reactivity was associated with expectancies of stimulation, which were associated with increased weekly drinking and problems. Reactivity was associated with increased weekly drinking and problems and this association was partially indirect through stimulating expectancies. Reactivity did not significantly predict sedating expectancies. The indirect effects from effortful control through consequence expectancies were not significant. There were curvilinear effects from consequence expectancies to drinking and problems. Specifically, the effect from consequence expectancies to drinking and problems was positive at low levels of expectancies, but became negative and significant at mean levels and above. Results of the invariance testing indicated that the model manifested similarly across university and MTurk respondents. These implications are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The current study tested the role of distress tolerance between cognitive schemas (emotional inhibition, defectiveness/shame, social isolation, and insufficient self-control) and eating disorder (ED) risk in a sample of 469 college students via structural equation analysis. While research indicates maladaptive cognitive schemas are positively associated with dysregulated eating, mechanisms of this relationship are not well established. Distress tolerance has been consistently associated with bulimia behaviors and body dissatisfaction; however, few studies have evaluated the role of distress tolerance in relation to cognitive schemas. In the current study, distress tolerance mediated associations between specific schemas of social isolation and insufficient self-control and eating disorder risk. These findings provide preliminary evidence suggesting specific cognitive schemas may contribute to low distress tolerance, which increases risk of ED-related behaviors and cognitions.

Results of neuroimaging datasets aggregated from multiple sites may be biased by site- specific profiles in participants’ demographic and clinical characteristics, as well as MRI acquisition protocols and scanning platforms. We compared the impact of four different harmonization methods on results obtained from analyses of cortical thickness data: (1) linear mixed-effects model (LME) that models site-specific random intercepts (LMEINT), (2) LME that models both site-specific random intercepts and age-related random slopes (LMEINT+SLP), (3) ComBat, and (4) ComBat with a generalized additive model (ComBat-GAM). Our test case for comparing harmonization methods was cortical thickness data aggregated from 29 sites, which included 1,343 cases with posttraumatic stress disorder (PTSD) (6.2-81.8 years old) and 2,067 trauma-exposed controls without PTSD (6.3-85.2 years old). We found that, compared to the other data harmonization methods, data processed with ComBat-GAM were more sensitive to the detection of significant case-control differences in regional cortical thickness (X2(3) = 34.339, p < 0.001), and case-control differences in age-related cortical thinning (X2(3) = 15.128, p = 0.002). Specifically, ComBat-GAM led to larger effect size estimates of cortical thickness reductions (corrected p-values < 0.001), smaller age-appropriate declines (corrected p-values < 0.001), and lower female to male contrast (corrected p-values < 0.001) in cases compared to controls relative to other harmonization methods. Harmonization with ComBat-GAM also led to greater estimates of age-related declines in cortical thickness (corrected p-values < 0.001) in both cases and controls compared to other harmonization methods. Our results support the use of ComBat-GAM for harmonizing cortical thickness data aggregated from multiple sites and scanners to minimize confounds and increase statistical power.

A growing number of studies have examined alterations in white matter organization in people with posttraumatic stress disorder (PTSD) using diffusion MRI (dMRI), but the results have been mixed, which may be partially due to relatively small sample sizes among studies. Altered structural connectivity may be both a neurobiological vulnerability for, and a result of, PTSD. In an effort to find reliable effects, we present a multi-cohort analysis of dMRI metrics across 3,047 individuals from 28 cohorts currently participating in the PGC-ENIGMA PTSD working group (a joint partnership between the Psychiatric Genomics Consortium and the Enhancing NeuroImaging Genetics through Meta-Analysis consortium). Comparing regional white matter metrics across the full brain in 1,426 individuals with PTSD and 1,621 controls (2174 males/873 females) between ages 18–83, 92% of whom were trauma-exposed, we report associations between PTSD and disrupted white matter organization measured by lower fractional anisotropy (FA) in the tapetum region of the corpus callosum (Cohen’s d=−0.11, p=0.0055). The tapetum connects the left and right hippocampus, structures for which structure and function have been consistently implicated in PTSD. Results remained significant/similar after accounting for the effects of multiple potentially confounding variables: childhood trauma exposure, comorbid depression, history of traumatic brain injury, current alcohol abuse or dependence, and current use of psychotropic medications. Our results show that PTSD may be associated with alterations in the broader hippocampal network.

Purpose Risk factors of negative affect, body dissatisfaction, distress tolerance, and negative urgency are independently associated with bulimia symptoms and non-suicidal self-injury (NSSI). However, relationships of these risk factors within comorbid presentations are not fully understood. The current study examined specific roles of these risk factors within this relationship. Methods An at-risk community sample of young adults (N = 429) completed an online survey of negative affect, body dissatisfaction, distress tolerance, negative urgency, bulimia symptoms, and NSSI. Results A hypothesized path model was a good fit to the data. Results indicated direct paths from body dissatisfaction, negative urgency, and distress tolerance to bulimia symptoms. Negative urgency, distress tolerance, and bulimia symptoms were directly associated with NSSI. Consistent with hypotheses, distress tolerance and negative urgency acted as vulnerability factors, increasing the strength of associations between bulimia symptoms and NSSI. Distress tolerance also strengthened associations between negative urgency and NSSI. In addition to the direct effect, negative urgency was indirectly associated with NSSI via body dissatisfaction bulimia. Hypothesized indirect effects through distress tolerance were not supported. Conclusions Results support etiological models of bulimia and NSSI, and suggest deficits in emotion regulation strengthen risk of comorbid presentations. Furthermore, individuals with greater impulsivity and difficulty tolerating distress are at increased risk of engaging in both bulimia behaviors and NSSI, providing targets for clinical intervention. Level of evidence Level V, cross-sectional descriptive study.

The current study examined emotion regulation variables (alexithymia, negative urgency, distress tolerance) and their relationship to traumatic event exposure, emotional intelligence (EI), and heal...

OBJECTIVE: To estimate a network model of risk and resilience factors of suicidal ideation among veterans. METHODS: Two network models of suicidal ideation among OIF/OEF/OND veterans (N = 276) incorporated key disorders, traumatic stress, and resilience constructs to contextualize suicidal ideation. RESULTS: Childhood trauma was positively connected with suicidal ideation and harassment and inversely connected with social support and distress tolerance. This exemplifies long-lasting associations between childhood trauma and re-victimization, emotion regulation, and ability to form supportive social relationships. A subsequent model including lower-order facets indicated that combat trauma was predominantly associated with PTSD-intrusion symptoms. CONCLUSIONS: This study highlights the importance of addressing both risk and resilience to reduce suicide risk among veterans and increases understanding of factors that contribute to suicidal ideation.

Posttraumatic stress disorder (PTSD) is associated with elevated risk of both alcohol use disorder (AUD) and related conduct problems, which are associated with behavioral and emotional dysregulation. We conducted an intensive longitudinal burst design study with 10 weeks of experience sampling over the course of 1.5 years with 250 veterans of recent conflicts. We tested time-series models of daily associations between posttraumatic stress symptoms (PTSS), alcohol dependence syndrome, and conduct problems. Exacerbations of PTSS predicted higher dependence syndrome and conduct problems the next day. This effect was significant after controlling for both concurrent (i.e., same-day) associations between drinking and the outcomes as well as the strength of associations between the outcomes from one day to the next (i.e., autoregression). Affect lability and disinhibition were hypothesized vulnerability factors increasing the strength of within-person predictors of dependence syndrome and conduct problems. Lability and disinhibition were associated with greater dependence syndrome symptoms and conduct problems over the follow-up period. Consistent with expectation, lability rather than disinhibition increased the association between drinking and dependence syndrome as well as the strength of association between dependence syndrome symptoms from one day to the next. Moderating effects of disinhibition in the conduct problems model were not significant. Importantly, results indicated reciprocal associations over time. Lability potentiated the association between dependence syndrome symptoms and next day PTSS, whereas disinhibition potentiated the association between conduct problems and next day PTSS. Results demonstrate complex dynamic associations between PTSS, AUD symptoms, and conduct problems over time indicative of broad regulatory impairments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

IntroductionCortical thickness (CT) and surface area (SA) are established biomarkers of brain pathology in posttraumatic stress disorder (PTSD). Structural covariance networks (SCN) constructed from CT and SA may represent developmental associations, or unique interactions between brain regions, possibly influenced by a common causal antecedent. The ENIGMA-PGC PTSD Working Group aggregated PTSD and control subjects’ data from 29 cohorts in five countries (n=3439).MethodsUsing Destrieux Atlas, we built SCNs and compared centrality measures between PTSD subjects and controls. Centrality is a graph theory measure derived using SCN.ResultsNotable nodes with higher CT-based centrality in PTSD compared to controls were left fusiform gyrus, left superior temporal gyrus, and right inferior temporal gyrus. We found sex-based centrality differences in bilateral frontal lobe regions, left anterior cingulate, left superior occipital cortex and right ventromedial prefrontal cortex (vmPFC). Comorbid PTSD and MDD showed higher CT-based centrality in the right anterior cingulate gyrus, right parahippocampal gyrus and lower SA-based centrality in left insular gyrus.ConclusionUnlike previous studies with smaller sample sizes (≤318), our study found differences in centrality measures using a sample size of 3439 subjects. This is the first cross-sectional study to examine SCN interactions with age, sex, and comorbid MDD. Although limited to group level inferences, centrality measures offer insights into a node’s relationship to the entire functional connectome unlike approaches like seed-based connectivity or independent component analysis. Nodes having higher centrality have greater structural or functional connections, lending them invaluable for translational treatments like neuromodulation.

Emotion regulation strategies may help explain the risk of experiencing posttraumatic stress disorder (PTSD) symptoms among adults with a history of child maltreatment. However, no study to date has examined the roles of both thought suppression and cognitive reappraisal in the association between childhood maltreatment and PTSD symptoms.The current study sought to understand the associations between childhood maltreatment, thought suppression, cognitive reappraisal, and PTSD symptoms while controlling for negative affect and gender.Data were collected on 660 university students (71 % female) ages 18-25 between 2013 and 2014. Participants completed self-report measures of childhood maltreatment, PTSD symptoms, and emotion regulation strategies.A structural equation model was tested to examine the direct and indirect effects from childhood maltreatment to PTSD symptoms via thought suppression and cognitive reappraisal, over and above gender and negative affect.Childhood maltreatment was directly associated with PTSD symptoms (β = 0.28, SE = 0.04, p.001). Childhood maltreatment also had a significant indirect effect on PTSD via cognitive reappraisal (β = 0.01, CI 95 % [0.00, 0.03]), but not through thought suppression, although (β = 0.01, CI 95 % [-0.00, 0.04]) thought suppression was significantly positively associated with PTSD symptoms (β = 0.21, SE = 0.04, p.001).The present study sheds light on the effect of childhood maltreatment and two commonly used emotion regulation strategies on PTSD symptoms.

We tested a dynamic structural equation model (DSEM; Asparouhov, Hamaker, & Muthen, 2018) of positive and negative affect in 254 veterans with approximately 1.5 years of experience sampling data. The analysis provided estimates of several aspects of veteran's emotional experience including "trait" positive and negative affect (i.e., mean levels), inertia (i.e., tendency for emotions to self-perpetuate), innovation variance (conceptualized as lability, reactivity, or exposure to stressors), and cross-lagged associations between positive and negative affect. Veterans with higher trait negative affect had more negative affect inertia and innovation variance. This suggests a pattern whereby the veteran has more negative reactions, and negative emotions, in turn, tend to maintain themselves, contributing to higher trait negative affect. In contrast, veterans with higher trait positive affect exhibited more positive affect innovation variance (e.g., positive reactivity). Although veterans showed some consistency in dynamics across emotions (e.g., positive and negative reactivity were positively correlated), trait positive and negative affect were not significantly associated. Veterans with higher posttraumatic stress symptoms (PTSS) at baseline exhibited higher reactivity to negative events, less positive affect, and more negative affect during the follow-up. Veterans with higher distress tolerance reported not only lower PTSS but also a more adaptive pattern of affective experience characterized by lower inertia and reactivity in negative affect and more positive lagged associations between negative affect and subsequent positive affect. The results demonstrated that distress tolerance and PTSS in veterans were associated with dynamics of positive and negative emotion over time, suggesting specific differences in affect regulation processes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Drunkorexia is characterized by a group of behaviors designed to minimize caloric intake while maximizing levels of alcohol intoxication. Individuals plan and modify their diet, via skipping meals, exercising, or purging, to save calories for a night of alcohol consumption. Minimal research has examined risk factors related to drunkorexia, and little is known regarding associated problems. We used structural equation modeling to test associations between coping and enhancement motives, drive for thinness, body dissatisfaction, and disordered eating (i.e., bulimia behaviors) and drinking among an at-risk college population (N = 364). Drive for thinness and alcohol coping motives were positively associated with drunkorexia. Notably, drunkorexia was associated with alcohol-related outcomes, but not bulimia. While common risk factors are shared with eating pathology, drunkorexia appears to be a unique construct apart from bulimia behaviors. Results indicate drunkorexia behaviors may extend past normative drinking and place individuals at increased risk of alcohol-related problems. The current study contributes to greater understanding of functional models and maladaptive outcomes related to drunkorexia behaviors.

Impulsivity, a multidimensional behavioral mechanism, commonly preceding externalizing maladaptive behavior and psychopathology, is a diagnostic criterion central to both antisocial and borderline personality disorders (American Psychiatric Association; APA, 2013). This study tested a path model of associations between five facets of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking), borderline personality features, antisocial personality features, and two alcohol outcomes (consumption and alcohol-related problems) in a sample of college students ( N = 624; 69% female, 31% male) between the ages of 18–25 ( M = 19.77, SD = 1.55). The model demonstrated good fit with χ 2 (14, N = 624) = 17.48, p = .231; RMSEA = .020 [90% CI: .000–.046]; CFI = .998; SRMR = .019. Negative urgency and (lack of) perseverance predicted borderline personality features. Positive urgency, sensation seeking, (lack of) premeditation, and negative urgency predicted antisocial personality features. Antisocial, but not borderline personality features, were significantly associated with alcohol consumption. However, both antisocial and borderline personality features significantly predicted alcohol problems. Overall, the results demonstrate that impulsivity facets can differentially predict personality psychopathology and illustrate distinct paths to alcohol consumption and problems.

Sexual abuse prior to age 18 may put some women at risk for engaging in sexual risk taking. This association could exist, in part, as a result of the impact of posttraumatic stress symptoms on behavioral regulation. The current study utilized a path analysis to investigate the association between severity of sexual abuse before age 18, posttraumatic stress symptoms, poor behavioral regulation, and expected engagement in sexual risk taking among college women. The sample consisted of 88 college women with experiences of sexual abuse prior to the age of 18. Severity of sexual abuse predicted posttraumatic stress symptoms. In addition, posttraumatic stress symptoms predicted poor behavioral regulation, which in turn predicted expected engagement in sexual risk taking. These findings indicate functional mechanisms involved in sexual decision making of women who have had past sexual abuse and experience posttraumatic stress symptoms.

OBJECTIVES: This study fills a gap in the literature by examining the relationship between two types of narcissism, vulnerable and grandiose, and five alcohol-related outcomes (i.e., alcohol use, alcohol problems, evaluation and expectancies of problems, and readiness to change). PARTICIPANTS: 345 college students (28% male, 72% female) from a Midwestern university were recruited from undergraduate psychology courses from April 2015 to October 2016. METHODS: Participants completed an online survey with questionnaires measuring the variables of interest. Multiple regression analyses were used to test the hypotheses. RESULTS: Grandiose narcissism was a positive predictor of alcohol consumption and a positive (i.e., good) evaluation of alcohol-related problems. Vulnerable narcissism was a positive predictor of alcohol-related problems, problem recognition (i.e., readiness to change), and problem expectancies. CONCLUSIONS: The results speak to the effects that different types of narcissism have on alcohol use, alcohol problems and attitudes towards alcohol problems among young adults.

Introduction The purpose of this study was to examine associations between inhibitory (sensitivity to punishment [SP], adaptive metacognition) and facilitatory (sensitivity to reward [SR], maladaptive metacognition) factors of alcohol consumption and problems among young adults. Methods Three hundred fifty-five young adults (ages 18–25, 61% female) recruited from Amazon Mechanical Turk and a large public midwestern university in the United States self-administered a Web survey. Two multiple regression models were tested. Results SR significantly moderated the effects of SP and the maladaptive metacognition (MC) subscale Uncontrollability/Danger on alcohol consumption. Alcohol problems were also significantly predicted by SR and Uncontrollability/Danger. The interaction between SR and SP on alcohol problems was conditional upon levels of the maladaptive MC subscale Lack of Cognitive Confidence, with a significant moderating effect only at high levels of Lack of Cognitive Confidence. Conclusions Consistent with the literature, individuals with high levels of SR coupled with low SP are at risk for increased alcohol consumption. This effect on drinking behaviors is further influenced by maladaptive MC, such that individuals characterized by high SR and low SP are significantly more likely to report more alcohol-related problems if they believe that worrying is dangerous and uncontrollable or lack cognitive confidence; however as SP increases, this effect significantly diminishes., Highlights • The association between SP and alcohol consumption is moderated by SR. • Beliefs of uncontrollability and SR increase alcohol consumption and problems. • The interaction of SR, SP, and alcohol problems is moderated by cognitive confidence.

Introduction The current study tested the role of distress tolerance in the relationship between three early maladaptive cognitive schemas (Abandonment, Defectiveness/Shame, and Insufficient Self-Control) and alcohol problems among college students (N = 364). Previous research suggests that maladaptive cognitive schemas may be a risk factor for alcohol-related problems. However, the mechanism underlying this association is unclear. One's tolerance for emotional distress may play an important role in understanding the nature of this association. Methods We tested a structural equation model where distress tolerance was expected to explain or moderate associations between early maladaptive schemas and alcohol outcomes. Results Results indicated distress tolerance partially mediated the relationships between schemas of Abandonment and Insufficient Self-Control and alcohol problems. Distress tolerance also significantly moderated the relationship between the Defectiveness/Shame schema and alcohol-related problems, reducing the strength of the association. Conclusions Distress tolerance is a modifiable risk factor and the results of this study support the inclusion of emotional regulation strategies in the prevention and treatment of alcohol problems among young adults.

Childhood maltreatment is a strong risk factor for increased alcohol use and alcohol-related problems. One possible explanation for these associations is the influence of dysfunctional attachment styles and interpersonal problems in adulthood. Individuals who have experienced childhood maltreatment are likely to develop maladaptive interpersonal styles due to insecure attachment. Maladaptive interpersonal styles may increase emotional distress, which in turn, can make these individuals vulnerable to alcohol use and alcohol-related problems. Using data from 508 undergraduate students, this study examined the associations between three types of childhood maltreatment (i.e., sexual abuse, punishment that included physical abuse, and a negative home atmosphere that included neglect), alcohol use, and alcohol-related problems via insecure attachment and interpersonal problems. The results showed that punishment predicted alcohol problems via avoidant attachment and selfish interpersonal style. Sexual abuse and negative home atmosphere predicted alcohol consumption through anxious attachment and selfless interpersonal style. In addition, sexual abuse directly predicted alcohol problems. These findings provide new insights for the field of childhood maltreatment and addiction literature.

This study examined the relationships between emotion dysregulation, peer drinking norms, drinking motives, and alcohol-related outcomes among 435 college students. We examined the mediating roles of drinking motives when predicting alcohol consumption and related problems from the subscales of the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, 2004) via negative and positive reinforcement models. First, we hypothesized that individuals who lack in emotion regulation strategies or have difficulties in accepting negative emotions are more likely to drink to cope. Additionally, we hypothesized that individuals who act impulsively or become distracted when upset as well as those with higher peer drinking norms are more likely to drink for social and enhancement motives. The results of the path model indicated that limited access to emotion regulation strategies significantly predicted alcohol-related problems via both depression and anxiety coping motives, but did not predict alcohol consumption. Nonacceptance of emotional responses was not significantly associated with coping motives. Impulsivity had a significant direct relationship with alcohol problems. Difficulty in engaging in goal-directed behaviors predicted both enhancement and social motives, but only enhancement motives in turn predicted consumption. Norms indirectly predicted problems via enhancement motives and consumption. The results indicated that using alcohol to reduce negative or to increase positive emotions increases alcohol consumption and alcohol-related problems. Overall, results advance our understanding of the mechanisms of increased alcohol use and problems among college students.

This study tested a structural equation model linking reinforcement sensitivity to subsequent emotion-based impulsivity (i.e., positive and negative urgency), alcohol use, and risky sexual behavior among a sample of 753 undergraduate drinkers. A hypothesized Sensitivity to Punishment (SP) × Sensitivity to Reward (SR) interaction significantly predicted both positive and negative urgency. At low levels of SR, SP had a significant negative effect on positive urgency and a significant positive effect on negative urgency. However, at high levels of SR, SP had significant positive effects on both types of urgency. Results indicated that positive and negative urgency mediate the associations between reinforcement sensitivity and both alcohol use and risky sexual behavior. Moreover, results demonstrated that at low levels of SR, SP is indirectly associated with decreased alcohol use. However, as SR increases, SP is indirectly associated with increased alcohol use and risky sexual behavior, due to the joint effect of high SP and SR on emotion-based impulsivity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

BackgroundPTSD and depression commonly co-occur and have been associated with smaller hippocampal volumes compared to healthy and trauma-exposed controls. However, the hippocampus is heterogeneous, with subregions that may be uniquely affected in individuals with PTSD and depression.MethodsWe used random effects regressions and a harmonized neuroimaging protocol based on FreeSurfer (v6.0) to identify sub-structural hippocampal markers of current PTSD (C-PTSD), depression, and the interaction of these conditions across 31 cohorts worldwide (N=3,115;Mage=38.9±13.9 years). Secondary analyses tested these associations by sex and after modeling the simultaneous effects of remitted PTSD, childhood trauma, mild traumatic brain injury, and alcohol use disorder.ResultsA significant negative main effect of depression (n=800, vs. no depression, n=1456) was observed in the hippocampal tail (ß=−0.13) and CA1 (ß=−0.09) after adjusting for covariates and multiple testing (adjusted p’s (q)=0.028). A main effect of C-PTSD (n=1042 vs. control, n=1359) was not significant, but an interaction between C-PTSD and depression was significant in the CA1 (ß=−0.24, q=0.044). Pairwise comparisons revealed significantly smaller CA1 volumes in individuals with C-PTSD+Depression than controls (ß=−0.12, q=0.012), C-PTSD-only (ß=−0.17, q=0.001), and Depression-only (ß=−0.18, q=0.023). Follow-up analyses revealed sex effects in the hippocampal tail of depressed females, and an interaction effect of C-PTSD and depression in the fimbria of males.ConclusionsCollectively our results suggest that depression is a stronger predictor of hippocampal volumetry than PTSD, particularly in the CA1, and provide compelling evidence of more pronounced hippocampal phenotypes in comorbid PTSD and depression compared to either condition alone.

Alexithymia is a personality construct characterized by difficulties in identifying and describing emotions. Previous research has identified a positive association between alexithymia and aggression, and impulsivity may account for some of that association. This study tested a path model of associations between alexithymia, five facets of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking), and verbal and physical aggression in a sample of 503 undergraduate students. Alexithymia had significant positive associations with all facets of impulsivity except for sensation seeking. Negative urgency and (lack of) premeditation mediated the relationship between alexithymia and verbal aggression. Positive urgency, negative urgency, and (lack of) premeditation mediated the relationship between alexithymia and physical aggression. Positive urgency also moderated the relationship between alexithymia and both forms of aggression, increasing the strength of those associations. These results highlight the role of emotion dysregulation in the context of aggression and support the use emotion regulation skills training in anger and aggression management programs.

Sexual assault history, secondary cognitive appraisals, and a dual-process model of self-regulation were examined as predictors of women’s intended behavioral responses to hypothetical sexual aggression. College women ( N = 435) read a sexually aggressive scenario and rated their intentions to engage in assertive, polite, and passive behavioral responses. Results indicated secondary cognitive appraisals predicted less assertive, more polite, and more passive responses. Good self-control predicted assertive and polite responses, while sexual assault history and poor regulation predicted passive responses. Poor regulation significantly moderated the relationship between secondary cognitive appraisals and passive behavioral responses. Implications for the prevention of sexual assault are discussed.

This study modelled associations between gender, ruminative cognitive style, alcohol use, and the time course of negative affect over the course of 43,111 random assessments in the natural environment. Participants (N = 263) completed 49 days of experience sampling over 1.3 years. The data indicated that rumination at baseline was positively associated with alcohol dependence symptoms at baseline as well as higher negative affect over the course of the study. Consistent with negative reinforcement models, drinking served to decrease the persistence of negative affect from moment to moment. However, this ameliorative effect of drinking was evident only among women, suggesting an increased risk for negative reinforcement driven drinking behaviour. In addition, rumination appeared to counteract the desired effects of alcohol on mood among women. This suggests that women who ruminate more may be motivated to consume larger amounts of alcohol to achieve the desired effects. Overall, the results indicate that ruminative cognitive style and the persistence of negative affect from moment to moment may reflect an individual vulnerability for the development of alcohol use disorder especially among women.

This study tested a path model of relationships between military sexual trauma (MST), combat exposure, negative urgency, posttraumatic stress disorder (PTSD) symptoms, and alcohol use and related problems. The sample consisted of 86 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans who reported drinking at least one alcoholic beverage per week. PTSD mediated the relationships between MST and alcohol-related problems, negative urgency and alcohol-related problems, and combat exposure and alcohol-related problems. In addition, negative urgency had a direct effect on alcohol problems. These results indicate that MST, combat exposure, and negative urgency independently predict PTSD symptoms and PTSD symptoms mediate their relationship with alcohol-related problems. Findings support previous literature on the effect of combat exposure and negative urgency on PTSD and subsequent alcohol-related problems. The current study also contributes to the limited research regarding the relationship between MST, PSTD, and alcohol use and related problems. Clinical interventions aimed at reducing emotional dysregulation and posttraumatic stress symptomology may subsequently improve alcohol-related outcomes.

This study tested a multilevel structural model of associations between two aspects of self-control (effortful control and reactivity), self-control demands, alcohol consumption, and alcohol problems and related risk behaviors using daily diary data from 196 young adults (4,177 person-days). Self-control demands were hypothesized to be positively associated with alcohol consumption and alcohol problems and related risk behaviors both within- and between-persons. At the between-person level, self-control demands were hypothesized to mediate the association between trait self-control and alcohol problems and related risk behaviors. At the within-person level, self-control demands had a direct positive effect on alcohol problems and related risk behaviors, over and above alcohol consumption. However, contrary to expectation, self-control demands were inversely associated with alcohol consumption. In contrast, self-control demands were positively associated with alcohol consumption at the between-person level and partially mediated the positive effects of reactivity on consumption and alcohol problems and related risk behaviors. That is, reactivity was associated with higher perceived self-control demands, which in turn predicted higher rates of consumption and alcohol problems and related risk behaviors. Effortful control was not significantly associated with alcohol consumption or self-control demands. The pattern of self-control demand effects at the within-person level suggest that young adults are less likely to drink when struggling to manage their day-to-day behavior, yet if they do drink they are more susceptible to negative consequences. Trait effects suggest that individual differences in self-control may be associated with alcohol use patterns in part attributable to development of, and response to, structured daily routines. (PsycINFO Database Record

This study examined negative control (ie, perceived lack of control over life outcomes) and need for control as predictors of alcohol-problem recognition, evaluations (good/bad), and expectancies (likely/unlikely) among college students. The study also explored the interaction between the need for control and alcohol consumption in alcohol-related outcomes.Participants were a convenience sample of 500 college students from a rural Midwest university. Data were collected during the 2009-2010 academic year.Participants completed a survey assessing control and alcohol-problem recognition, evaluations, and expectancies.Negative control demonstrated a significant positive association with alcohol-problem recognition, evaluations, and expectancies after controlling for gender and alcohol consumption. Need for control did not have a main effect. However, the interaction was significant in that the association between need for control and negative evaluation of alcohol problems was strongest among participants with the highest levels of alcohol consumption.These results demonstrate that individuals' differences in sense of control are associated with alcohol-problem recognition, evaluations, and expectancies in young adults.

College student drinking is a public health concern with potentially serious consequences. A growing body of literature indicates perceived parental approval of alcohol use is associated with drinking outcomes in college populations, and that parent-based interventions may be a viable way to reduce alcohol use on campus. However, researchers have not yet identified the mechanism responsible for this relationship. In this study, a path model was used to look at the relationship between perceived parental approval of drinking and negative consequences of alcohol use among undergraduate students (N = 632) via two mechanisms: perceived friends’ approval of drinking and perceived parental monitoring. The path model specified in this study indicated that perceived parental approval of drinking is associated with negative consequences of alcohol use, and that this effect is not fully attributed to perceived parental monitoring, injunctive norms of friends, gender or weekly alcohol consumption. As hypothe...

Evidence suggests that for young adults, intimate partners influence each other's drinking patterns. Therefore, exploration of variables related to intimate partner relationships (such as attachment style) could broaden the current understanding of risk factors for alcohol problems in this demographic.The current study examined the role of drinking context in the relationships among insecure attachment, alcohol problems, and relationship satisfaction. A path model was hypothesized where the relationship between insecure attachment and alcohol problems would be explained via two distinct drinking contexts (i.e., drinking with one's partner and drinking away from one's partner). It was also hypothesized that the relationship between insecure attachment and relationship satisfaction would be explained via these same two drinking contexts.Participants were 194 undergraduate students ages 18-25 who reported being in a monogamous intimate partner relationship for at least 90 days and had also consumed alcohol in the past 90 days. The sample was comprised of 76% women and 24% men.The hypothesized direct relationship from anxious attachment to alcohol problems was significant; there were also significant direct paths from both anxious and avoidant attachment to relationship satisfaction. The hypotheses regarding indirect relationships were not supported.The results of this study contribute to the existing literature, in that they suggest that drinking in the context of an intimate relationship may not directly affect relationship satisfaction in this population. However, relationship functioning still appears to be an important variable to consider in the prevention and treatment of alcohol-related problems affecting college students.

Distress tolerance is defined as the individualrsquo;s capacity to experience and withstand negative psychological states. The goal of this study was to examine the psychometric properties and the factor structure of the Spanish version of the Distress Tolerance Scale (DTS) and to test its relationship with psychopathological symptoms and personality.A sample of 650 participants completed the DTS, the Eysenck Personality Questionnaire Revisedndash;Abbreviated) (EPQR-A), and the Symptom Assessment-45 Questionnaire (SA-45).The DTS showed good internal consistency (Cronbachrsquo;s alpha) and adequate temporal stability (7-month test-retest). Results of a confirmatory factor analysis supported the hypothesized 4-factor structure (tolerance, appraisal, absorption, and regulation) that load onto a higher-order general factor. A structural equation model (SEM) was tested to provide evidence of construct validity. Neuroticism was inversely associated with distress tolerance, and distress tolerance partially mediated the effects of neuroticism on current symptoms. Results indicated that the Spanish DTS mediated associations between personality traits and current psychiatric symptoms.Results support the use of this version as a useful tool for assessing distress tolerance in clinical and research settings in Spanish-speaking countries. In addition, we found that distress tolerance may form a link between neuroticism and psychopathology.

This fMRI study tested a model of combat trauma, posttraumatic stress symptoms (PTSS), alcohol use, and behavioral and neural responses to emotional cues in 100 OIF/OEF/OND veterans. Multilevel structural equation models were tested for left and right dorsal ACC (dACC), rostral ACC (rACC), and amygdala blood-oxygen- level dependent responses during the emotional counting Stroop test and masked faces task. In the Stroop task, combat exposure moderated the effect of combat stimuli resulting in hyperactivation in the rACC and dACC. Activation in the left amygdala also increased in response to combat stimuli, but effects did not vary as a function of combat severity. In the masked faces task, activation patterns did not vary as a function of stimulus. However, at the between-person level, amygdala activation during the masked faces task was inversely associated with PTSS. In respect to behavioral outcomes, higher PTSS were associated with a stronger Stroop effect, suggesting greater interference associated with combat words. Results are consistent with the premise that combat trauma results in hyperactivation in the ACC in response to combat stimuli, and, via its effect on PTSS, is associated with deficits in cognitive performance in the presence of combat stimuli. Across tasks, predeployment drinking was inversely associated with activation in the dACC but not the rACC or amygdala. Drinking may be a buffering factor, or negatively reinforcing in part because of its effects on normalizing brain response following trauma exposure. Alternatively, drinking may undermine adaptive functioning of the dACC when responding to traumatic stress cues. (PsycINFO Database Record

This study tested the role of affect lability and disinhibition in mediating associations between PTSD symptoms and two forms of alcohol-related problems, dependence syndrome symptoms (e.g., impaired control over consumption) and conduct problems (e.g., assault, risk behaviors). Genotype at the serotonin transporter linked polymorphic region (5-HTTLPR) was hypothesized to moderate associations between traumatic stress and PTSD symptoms. In addition, the study tested whether childhood traumatic stress moderated associations between combat trauma and PTSD symptoms. Participants were 270 OIF/OEF/OND veterans. The hypothesized model was largely supported. Participants with the low expression alleles of 5-HTTLPR (S or LG) exhibited stronger associations between childhood (but not combat) traumatic stress and PTSD symptoms. Affect lability mediated the associations between PTSD symptoms and alcohol dependence symptoms. Behavioral disinhibition mediated associations between PTSD symptoms and conduct related problems. Conditional indirect effects indicated stronger associations between childhood traumatic stress and lability, behavioral disinhibition, alcohol consumption, AUD symptoms, and associated conduct problems via PTSD symptoms among those with the low expression 5-HTTLPR alleles. However, interactions between combat trauma and either childhood trauma or genotype were not significant. The results support the hypothesis that affect lability and behavioral disinhibition are potential intermediate traits with distinct associations with AUD and associated externalizing problems.