The association among posttraumatic stress disorder clusters, problematic alcohol and cannabis use, and substance use motives.

Research indicates that young adults experience higher rates of traumatic events and substance misuse, potentially leading to reliance on maladaptive coping mechanisms and numerous harmful consequences. The relationship between PTSD symptom clusters and substance misuse is complex and varies across studies, highlighting the need for targeted research, particularly in the young adult population given the demonstrated vulnerabilities. Identifying unique associations of PTSD and problematic substance use can facilitate early and tailored interventions. Two cross-sectional studies aimed to empirically evaluate whether PTSD clusters uniquely associate with problematic alcohol and/or cannabis misuse and motives, while considering potential moderating variables such as gender. Additionally, the studies incorporated participants’ perspectives on the relationship between PTSD and substance use. PTSD symptoms – particularly alterations in arousal and reactivity – explained unique variance in total alcohol use and all four drinking motives in both studies, most strongly for coping; this cluster also related to total cannabis use and coping-motivated cannabis use. Surprisingly, reexperiencing was negatively associated with several alcohol/cannabis outcomes. Participants who perceived trauma as influencing their alcohol or cannabis use endorsed higher PTSD symptoms and markedly greater coping-motivated use, underscoring a functional (self-medication) pattern. To the author’s knowledge, this is the first study to examine unique PTSD cluster associations with problematic alcohol and cannabis use, applying the updated DSM-5-TR criteria in a young adult population, as well as the first to consistently identify the alterations in arousal and reactivity cluster as uniquely related to problematic substance use across two independent samples. The current results have clinical implications, such as the importance of systematically screening for substance misuse in working with individuals with PTSD, with special attention to coping motives and to elevations in the alterations in arousal and reactivity cluster, and potentially front-loading skills targeting this cluster (e.g., distress tolerance, mindfulness, sleep and arousal regulation).

Name thesis:degree_name

Psy.D.

Level thesis:degree_level

Doctoral

Grantor

Baylor University.

Year dc:date.issued

2026

Author dc:creator

• Leonard, Kiara Dylan, 1995-

Advisor dc:contributor.advisor

• Dolan, Sara Lynn.

• Posttraumatic stress disorder (PTSD)
• Alcohol use.
• Substance use motivations.
• Cannabis use.
• Posttraumatic stress disorder (PTSD) symptoms.
• Posttraumatic stress disorder (PTSD) clusters.
• Trauma.

Statement dc:rights

• Baylor University works are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. Contact libraryquestions@baylor.edu for inquiries about permission.

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/2104/14510

OAI identifier oai:identifier

oai:baylor-ir.tdl.org:2104/14510