(PS14-38) PTSD Alcohol Expectancies Among Those with Sexual Assault Exposure vs. Other Trauma Exposure Types

Introduction: Sexual assault (SA) disproportionally burdens women, conferring considerable risk for various adverse mental health outcomes. In particular, SA survivors who develop posttraumatic stress disorder (PTSD) experience uniquely high rates of problem alcohol use. Efforts to characterize maladaptive cognitions that increase the likelihood of alcohol use in response to SA - relative to other trauma exposure - may help inform personalized cognitive and behavioral interventions for PTSD-related drinking among SA survivors. Positive PTSD-alcohol expectancies (PAE) represent beliefs that alcohol will reduce PTSD symptoms, and they have been associated with problematic drinking. Yet, little is known about whether SA survivors endorse unique positive PAE. This study compared positive PAE across individuals with PTSD with or without SA trauma exposure. We hypothesized that those with SA exposure would endorse more positive Negative Cognition and Mood PAE than those without SA exposure.

Methods: Frequent drinking, non-treatment-seeking adults with past-month PTSD were recruited through print/online advertisements. Participants (n = 54; M_age = 35 years) were predominantly female (63%) who identified as straight (85%), comprising 50% Black, 35% White, 6% Asian, 4% Multiracial, and 6% other racial group. Participants reported on PAE and completed the Life Events Checklist to assess for SA exposure and a clinical interview assessing past-month PTSD. SA exposure was defined as attempted or completed rape and/or other uncomfortable or unwanted sexual experience. Independent samples t-tests were used to compare individuals with and without SA exposure on four domains of positive PAE (e.g., Intrusion, Avoidance, Negative Cognition and Mood, and Arousal/Reactivity symptoms).

Results: SA was endorsed by 44% of participants. Those with SA exposure reported significantly more positive Negative Cognition and Mood PAE (M = 4.22, SD = 0.62) than those without such exposure (M = 3.87, SD = 0.66); t(52) = -2.02, p = .048, d = -0.55. There were no group differences on other PAE domains.

Discussion: Findings highlight SA survivors’ unique cognitive drinking risk, through expectations that alcohol will reduce Negative Cognition and Mood PTSD symptoms. Results, though preliminary, might support a new line of work that seeks to personalize interventions by identifying trauma-specific PTSD and alcohol-related cognitions. Women are a unique and vulnerable group for experiencing SA and often have poor alcohol outcomes. Future research should explore whether cognitive and behavioral interventions aimed at reducing positive Negative Cognition and Mood PAE cognitions help reduce the unique alcohol risks and mental health sequelae following experiences of SA.