Avoidance Coping as a Vulnerability Factor for Negative Drinking Consequences Among Injury Survivors Experiencing PTSD Symptoms:An Ecological Momentary Assessment Study

ABSTRACT

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.

KEYWORDS:

• Ecological momentary assessment
• avoidance coping
• posttraumatic stress disorder (PTSD)
• alcohol
• injury

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Because participants were asked to report on their experiences since the last assessment and because the time lag between assessments could vary between participants due to the protocol schedule, we also tested full models with covariates plus the time lag between assessments. The statistical significance of the main effects associated with PTSS (IRR = 1.06, SE = 0.04, p = .09; IRR = 1.06, SE = 0.04, p = .09), overall avoidance coping (IRR = 1.03, SE = 0.03, p = .20), cognitive avoidance coping (IRR = 1.03, SE = 0.04, p = .45), and behavioral avoidance coping (IRR = 1.04, SE = 0.05, p = .41) were unchanged. The statistical significance of the PTSS-avoidance coping (IRR = 1.01, SE = 0.01, p = .35), PTSS-cognitive avoidance coping (IRR = 1.02, SE = 0.01, p = .06), and PTSS-behavioral avoidance coping (IRR = 0.99, SE = 0.01, p = .39) interactions were also unchanged. Because the inclusion of a time lag variable results in a loss of information (no value can be calculated for the first day, first assessment for each participant), we report models without this variable to utilize all data available.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.