Abstract
BACKGROUND AND OBJECTIVES: Posttraumatic stress symptoms are related to higher rates of heavy episodic drinking (HED). Given that women are at higher risk for posttraumatic stress symptoms and long-term health effects from HED, identification of factors related to HED among women with posttraumatic stress symptoms could have important implications for prevention and treatment. One such factor is romantic relationship impairment given the association between posttraumatic stress and greater relationship conflict. Further, women, but not men, are more likely to drink in heavy quantities when experiencing relationship difficulties. Thus, it may be that for women, but not men, PTSD is related to heavier drinking via relationship impairment. METHOD: This study tested whether sex moderated the indirect effect of posttraumatic stress symptoms on HED through relationship impairment among 319 community-recruited adults with probable PTSD who endorsed current hazardous alcohol use and were living with a romantic partner and/or married. RESULTS: Posttraumatic stress symptoms were positively correlated with HED and relationship impairment. The indirect effect of posttraumatic stress symptoms on HED through relationship impairment was moderated by sex, such that posttraumatic stress symptoms were related to HED indirectly via relationship impairment for women, but not men. DISCUSSION AND CONCLUSIONS: Results highlight the importance of considering sex to better understand the role of posttraumatic stress symptoms on HED. Failure to consider sex could obfuscate the impact of factors relevant to women. SCIENTIFIC SIGNIFICANCE: This is the first known study to examine the differential relations between posttraumatic stress, romantic relationship impairment, and HED by sex.