Epidemiological review uncovers a durable bidirectional comorbidity between trauma and alcohol misuse in clinical and veteran populations, highlighting complex reciprocal causal pathways.
For more than 40 years, research has shown that individuals with post-traumatic stress disorder (PTSD) use alcohol and experience alcohol use disorder (AUD) to a greater degree than those with no PTSD. AUD and PTSD have shown a durable comorbidity that has extended through decades and through changes in disorder definitions. Some research shows that veterans who have experienced PTSD have a high likelihood of developing AUD, perhaps reflecting the self-medication hypothesis. Other research shows that people with substance use disorder are likely to be exposed to traumatic situations and develop PTSD. These two areas of research could represent two separate relationships between PTSD and AUD. Finally, there is still no clear determination of which cluster of PTSD symptoms is most closely associated with AUD.
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