The effect of PTSD on World Health Organization risk drinking levels and reductions in a nationally representative sample.

OBJECTIVE

Reductions in alcohol use are associated with improved mental and physical health. Posttraumatic stress disorder (PTSD) may hamper drinking reductions via drinking to cope with symptoms. Using nationally representative data in those with trauma exposure, we aimed to determine whether PTSD symptoms were associated with (a) the World Health Organization risk drinking levels (WHO RDL) and (b) WHO RDL change over 3 years.

METHOD: We used baseline (2001-2002) and 3-year follow-up (2004-2005) National Epidemiologic Survey on Alcohol and Related Conditions data, including PTSD diagnosis, WHO RDL (abstinence, low, moderate, high, and very high risk based on mean drinks per day), and WHO RDL change (increased, one-, two-, three-level reduction, or reduced to abstinence). Multinomial logistic regression models tested study aims.

RESULTS

PTSD was associated with high-risk (OR = 1.39, p = .040) and very-high-risk drinking (OR = 2.09, p < .001) compared with low-risk drinking (n = 31,638). Baseline PTSD symptoms (retrospectively reported at the follow-up assessment) were associated with greater odds of increasing WHO RDLs over 3 years among those with initial low-risk drinking (OR = 1.36, p = .015; n = 17,948) and lower odds of reducing WHO RDLs among those with initial high-risk (OR = 0.40, p = .026; n = 648) or very-high-risk (OR = 0.21, p < .002; n = 678) drinking levels.

CONCLUSIONS

PTSD is associated with high-risk drinking, as well as increased and persistent problematic alcohol use over time. As such, PTSD should be considered and addressed in efforts to prevent or reduce risky alcohol use among those with high-risk drinking. (PsycInfo Database Record (c) 2026 APA, all rights reserved).