Testing gender effects on the mechanisms explaining the association between post-traumatic stress symptoms and substance use frequency

The present study examines gender differences in the mechanisms that explain the association between PTSD symptoms and substance use frequency in a sample of 182 urban substance users. Specifically, the current study examined gender differences in the role of two potential explanatory variables, namely, difficulties controlling impulsive behavior when distressed (IMP), and a lack of emotional awareness and clarity (AW/CLAR). Multiple-group path modeling (across males and females) was used to examine gender differences in the path coefficients from PTSD symptoms to IMP and AW/CLAR, and from these latter variables to drug use frequency. Results indicated that PTSD symptoms were associated with IMP and AW/CLAR, and these path coefficients did not vary by gender. However, gender differences emerged when considering the path coefficients from AW/CLAR and IMP to substance use frequency. Specifically, for women, the association between PTSD and substance use was partially explained by IMP, whereas for men, the association between PTSD and substance use was partially explained by AW/CLAR. The current study is the first to examine gender differences in mechanisms accounting for the association between PTSD and substance use frequency, and these results also support the value and importance of examining gender differences in mechanisms underlying PTSD–SUD comorbidity.