Differential mediating effects of PTSD symptom clusters on alcohol use and sleep in university students with trauma experiences: A multi-group analysis

This study investigates the differential mediating pathways of PTSD symptom clusters in the relationship between traumatic events and alcohol use or poor sleep quality in a sample of university students with traumatic life experiences using a path analysis. Gender difference was also examined using multi-group analysis. Male (N = 1471) and female (N = 528) university students completed an online mental health survey consisting of the Life Event Checklist, the Impact of Event Scale-Revised, the CAGE Questionnaire, and the Pittsburgh Sleep Quality Index. Results showed that traumatic events had a direct impact on both alcohol use and poor sleep quality. The indirect impact of traumatic events on alcohol use appeared to be through PTSD-avoidance, and the indirect impact of traumatic events on poor sleep quality appeared to be through PTSD-intrusion and PTSD-hyperarousal. A multi-group analysis showed that male students are 3.25 times more likely to use alcohol in response to traumatic stress than female students. Our findings suggest that there are differential mediating mechanisms of PTSD symptom clusters underlying alcohol use or poor sleep quality following traumatic events, indicating the importance of developing symptom-tailored therapeutic intervention.