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The Exploration of Depression as a Mediating Mechanism between Trauma and Alcohol Problems

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Introduction: Depression is one of the most prevalent mental illnesses in the United States, and is characterized by feeling sad or empty most of the day, nearly every day (American Psychiatric Association, 2013). The experience of childhood trauma is one of many factors that may lead to depression, while trauma…

Introduction: Depression is one of the most prevalent mental illnesses in the United States, and is characterized by feeling sad or empty most of the day, nearly every day (American Psychiatric Association, 2013). The experience of childhood trauma is one of many factors that may lead to depression, while trauma can also yield other adverse life outcomes, such as alcohol-related consequences (Felitti et al., 2001; Neumann, 2017). One of the specific aims of this investigation was to examine the direct influences of childhood trauma on depression. We also examined selected direct and indirect influences of childhood trauma on drinking outcomes through the potential mediating mechanism of depression. We examined three distinct drinking outcomes, 1) impaired control over drinking (i.e. the inability to stop drinking when intended), 2) heavy episodic drinking (four or more drinks on one occasion for men, four or more for women), and 3) alcohol-related problems. Methods: A survey was administered to 940 (466 women, 474 men) university students. Structural equation modeling was used to examine the data. Potential two- and three-path mediated effects were examined with the bias corrected bootstrap technique in Mplus (MacKinnon, 2008). Results: Emotional abuse was found to be positively associated with depression. In contrast, having an emotionally supportive family was found to be negatively associated with depression. Congruent with the Self-Medication Hypothesis, depression was found to be positively associated with impaired control over drinking. Physical neglect was found to be positively associated with impaired control. Lastly, emotional abuse was found to be indirectly linked to increased heavy episodic drinking and alcohol-related problems through depression and impaired control.
ContributorsBobel, Emily Rebecca Leslie (Author) / Patock-Peckham, Julie (Thesis director) / Glenberg, Arthur (Committee member) / Karoly, Paul (Committee member) / Department of Psychology (Contributor) / School of Criminology and Criminal Justice (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
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The direct & indirect links from facets of childhood trauma to arousability, impaired control, alcohol use, & alcohol-related problems.

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Hyper-arousal theory presumes that experiencing trauma can increase one’s sense of fight or flight responses or generalized sense of arousability (Riemann et al., 2010). While this theory has been examined in studies regarding insomnia (e.g. Schwandt et al., 2013) it has yet to be examine with dysregulated drinking outcomes such…

Hyper-arousal theory presumes that experiencing trauma can increase one’s sense of fight or flight responses or generalized sense of arousability (Riemann et al., 2010). While this theory has been examined in studies regarding insomnia (e.g. Schwandt et al., 2013) it has yet to be examine with dysregulated drinking outcomes such as impaired control over alcohol use. Impaired control over alcohol use (IC) reflects drinking beyond one’s own self-proscribed limits for one’s own drinking behaviors (Heather et al., 1993). According to multiple review papers on the topic (Leeman et al., 2012; 2014), IC is an understudied topic regarding alcohol use disorders (AUDs). Thus, we sought to explore a pathway from facets of childhood trauma (emotional, physical, & sexual abuse, & neglect) versus a supportive family to arousability to drinking outcomes (i.e. IC, alcohol use, & alcohol-related problems). Method: We fit a multiple-group structural equation model with 835 (368 women/ 467 men) university student volunteers. As our model failed the overall invariance test, χ2Δ (20 df) = 55.788, p < .001, we allowed our hypothesized model to moderate on sex. Results: The direct link from sexual abuse to both IC and alcohol-related-problems was stronger for men than women. Emotional abuse was directly linked to higher levels of arousability among women, whereas an emotionally supportive family was related to lesser degrees of arousability among men. Impaired control mediated the indirect link between higher levels of arousability and alcohol use for both sexes. Impaired control also mediated the indirect link between physical neglect and alcohol-related problems among both sexes. Higher levels of emotional abuse were indirectly linked to both more alcohol use & problems through increased arousability and in turn, more IC among women. Higher levels of sexual abuse were indirectly linked to more alcohol problems through higher degrees of impaired control among men. Conclusions: We found evidence in favor of the Hyper-arousability Theory regarding dysregulated drinking with a direct link between arousability and IC. While physical neglect appears to affect both sexes drinking behaviors, emotional abuse may play a stronger role for women than men, while sexual abuse may play a stronger role among men.
ContributorsOng, Annie (Author) / Patock-Peckham, Julie (Thesis director) / Infurna, Frank (Committee member) / McClure, Samuel (Committee member) / Barrett, The Honors College (Contributor) / Dean, W.P. Carey School of Business (Contributor) / Department of Psychology (Contributor)
Created2021-12