Sex Differences in Trauma and Alcohol Cue Creativity

Available research suggests that men and women may differ in their risk for and presentation of PTSD-AUD comorbidity; PTSD and AUD symptoms and diagnoses appear to be more strongly associated for women compared to men. The trauma and alcohol cue reactivity paradigm may be useful for understanding sex differences in PTSD-AUD risk, given that this paradigm has the potential to simultaneously assess markers of self-medication risk (e.g., craving and salivation to trauma cues) as well as general alcohol risk (e.g., craving and salivation to alcohol cues). The aim of this study was to evaluate sex differences in trauma and alcohol cue reactivity through a laboratory paradigm that allows for the examination of craving responses to personalized trauma narratives and alcohol cues in a sample of 200 trauma-exposed college students who use alcohol regularly. It was hypothesized that men would have a stronger craving response to the trauma narrative compared to women, consistent with stronger self-medication alcohol use. It was also hypothesized that PTSD symptoms would evidence a stronger association with trauma cue-elicited craving for women than men, given evidence that PTSD and AUD correlate more strongly for women than men. Finally, it was hypothesized that men would demonstrate a greater craving response to the alcohol cues compared to women, given evidence that men exhibit greater risk for AUD than women. Contrary to hypotheses, there was no effect of sex on narrative status or beverage cue (t = -0.843, p = .400; t = -0.237, p = .813, respectively) when predicting craving, nor was there an effect of sex on narrative status or beverage cue (t = 0.434, p = .665; t = -0.660, p = 0.510, respectively) when predicting salivation. These results suggest that sex differences in PTSD-AUD may not be due to sex differences in self-medication alcohol use or reactivity to alcohol cues.