Abstract
Posttraumatic stress disorder (PTSD) and alcohol misuse frequently co-occur following trauma exposure, with individuals often experiencing detrimental outcomes. The self-medication hypothesis postulates that those with posttraumatic stress symptoms are more likely to develop problematic drinking behaviors due to reliance on alcohol use to cope with trauma symptoms. This study aimed to identify if coping meta-skills – trauma coping self-efficacy and coping flexibility – as well as substance use (SU) coping mediated the pathways from PTSD symptoms to alcohol use using structural equation modeling. The sample of 336 trauma-exposed respondents was drawn from the general population and university undergraduates (70% women, 80% White). Participants completed online survey measures during the COVID-19 pandemic. A confirmatory factor analysis and structural equation model each produced satisfactory fit indices. Tests of indirect effects for the structural equation model demonstrated that PTSD symptoms had a significant indirect effect on problematic alcohol use behaviors via trauma coping self-efficacy and substance use coping (β = 0.15, 95% CI [0.10, 0.23], p < .001). These novel findings help to identify critical factors within the comorbid PTSD-alcohol use connection that may serve as intervention targets.