The 7-factor hybrid model of DSM-5 PTSD symptoms and alcohol consumption and consequences in a national sample of trauma-exposed veterans

- Relations between a 7-factor hybrid model of PTSD and 2-factor AUDIT model were examined.
- Negative affect, anhedonia, and dysphoric arousal comprise internalizing symptoms.
- Internalizing symptoms correlated with alcohol consequences over anxious arousal.
- Alcohol consequences are most related to the internalizing symptoms of PTSD.

The purpose of the present study was to investigate associations between the 7-factor hybrid model of DSM-5 posttraumatic stress disorder (PTSD) symptoms, which includes intrusions, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal symptoms, and alcohol consumption and consequences. A nationally representative sample of 916 trauma-exposed U.S. military veterans were administered the Trauma History Screen, PTSD Checklist-5, and Alcohol Use Disorders Identification Test. Confirmatory factor analyses were conducted to determine associations between the 7-factor hybrid model of PTSD symptoms, and alcohol consumption and consequences. Results revealed that lifetime dysphoric arousal (r = 0.31), negative affect (r = 0.30), and anhedonia (r = 0.29) symptom clusters were most strongly associated with past-year alcohol consequences. No significant associations were observed for alcohol consumption. While the cross-sectional study design does not allow one to ascertain causative associations between PTSD factors and alcohol consumption and consequences, results generally align with the self-medication hypothesis, as PTSD factors reflecting internalizing were most strongly related to alcohol-related consequences. These results underscore the importance of assessing for alcohol use problems in veterans who score highly on PTSD symptoms reflecting internalizing symptomatology.