PALTELL-THESIS-2020.PDF (598.7 kB)
Download file

The Influences of PTSD and Distress Tolerance on Trauma and Alcohol Cue Reactivity

Download (598.7 kB)
posted on 01.08.2020, 00:00 authored by Katherine Charlotte Paltell
Self-medication models posit that posttraumatic stress disorder (PTSD) increases risk for developing alcohol use disorder (AUD), due the tendency to use alcohol to cope with trauma-related negative affect and memories. However, successfully treating PTSD does not improve AUD outcomes compared to standard AUD treatment alone, suggesting that clinically impacting self-medication in PTSD-AUD may be nuanced. One promising clinical intervention target to decrease self-medication is distress tolerance (DT). The trauma and alcohol cue reactivity paradigm, which measures salivation and self-reported alcohol craving in response to four combinations of narrative (personalized trauma vs. neutral) and beverage (alcohol vs. water) cues, is well-suited to evaluate role of DT in comorbid PTSD-AUD. The current study evaluated DT in relation to trauma and alcohol cue reactivity (i.e., craving, salivation) in a high-risk sample of 185 university students (50.3% female) endorsing lifetime interpersonal trauma exposure and current weekly alcohol consumption. Forward-fitting linear mixed effects models were used to examine (a) the influence of the within-subjects factors (narrative cue, beverage cue) and covariates (DT, PTSD symptoms) on physiological and subjective craving, and (b) the role of DT in a moderated-mediation model of self-medication. Contrary to prediction, there were no main effects of DT in relation to craving (B = -0.281, p = .074) or salivation (B = -0.092, p = .217), and DT did not significantly interact with narrative cue to predict craving (B = 0.189, p = .184). However, DT significantly interacted with beverage cue in relation to craving (B = -0.293, p = .011), such that individuals low, as compared to high, in DT reported greater craving for alcohol in response to the alcohol, but not water, beverage cue. In the context of a moderated-mediation model of self-medication, DT did not moderate the association between negative affect and craving (t = 0.630, p = .529), or an association between trauma cue and negative affect (t = -0.674, p = .501). The findings suggest that among trauma-exposed young adult drinkers, low DT may not exacerbate self-medication use. Instead, DT may influence alternative processes of AUD risk, such as susceptibility to conditioned craving responses to alcohol.



Berenz, Erin


Berenz, Erin



Degree Grantor

University of Illinois at Chicago

Degree Level


Degree name

MA, Master of Arts

Committee Member

Herbener, Ellen Giedgowd, Grace

Submitted date

August 2020

Thesis type




Usage metrics