Posttraumatic stress disorder (PTSD) and alcohol misuse frequently co-occur following trauma exposure, with individuals often experiencing detrimental outcomes. The self-medication hypothesis postulates that those with posttraumatic stress symptoms are more likely to develop problematic drinking behaviors due to reliance on alcohol use to cope with trauma symptoms. This study aimed to identify if coping meta-skills – trauma coping self-efficacy and coping flexibility – as well as substance use (SU) coping mediated the pathways from PTSD symptoms to alcohol use using structural equation modeling. The sample of 336 trauma-exposed respondents was drawn from the general population and university undergraduates (70% women, 80% White). Participants completed online survey measures during the COVID-19 pandemic. A confirmatory factor analysis and structural equation model each produced satisfactory fit indices. Tests of indirect effects for the structural equation model demonstrated that PTSD symptoms had a significant indirect effect on problematic alcohol use behaviors via trauma coping self-efficacy and substance use coping (β = 0.15, 95% CI [0.10, 0.23], p < .001). These novel findings help to identify critical factors within the comorbid PTSD-alcohol use connection that may serve as intervention targets.

创伤后应激障碍（PTSD）和酒精滥用经常在遭受创伤后同时发生，个人常常会经历有害的后果。自我药疗假说假设，那些有创伤后应激症状的人由于依赖酒精来应对创伤症状，更有可能出现有问题的饮酒行为。本研究旨在利用结构方程模型确定应对元技能（创伤应对自我效能和应对灵活性）以及物质使用（SU）应对是否介导从 PTSD 症状到饮酒的途径。336 名遭受过创伤的受访者样本来自普通人群和大学本科生（70% 为女性，80% 为白人）。参与者在 COVID-19 大流行期间完成了在线调查措施。验证性因素分析和结构方程模型均产生了令人满意的拟合指数。结构方程模型的间接影响测试表明，PTSD 症状通过创伤应对自我效能和物质使用应对对有问题的饮酒行为产生显着的间接影响（β = 0.15，95% CI [0.10，0.23]，p <  . 001）。这些新发现有助于确定共病 PTSD-饮酒关联中的关键因素，这些因素可以作为干预目标。