Document Type

Article

Publication Date

2026

DOI

10.1080/20008066.2026.2635214

Publication Title

European Journal of Psychotraumatology

Volume

17

Issue

1

Pages

2635214

Abstract

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which are moderately heritable, frequently co-occur and contribute to significant public health burdens, particularly among economically disadvantaged urban communities. There are noted sex differences in PTSD and AUD outcomes, with evidence suggesting women have heightened susceptibility to stress-related alcohol use. Preliminary PTSD-AUD ecological momentary assessment (EMA) findings support bidirectional associations across clinical outcomes. However, no studies to date have used PTSD-AUD comorbidity models as organizing frameworks to examine the temporal ordering and stability of within-person symptom dynamics underlying the maintenance or exacerbation of PTSD and AUD symptoms, including bidirectional and shared-liability processes. Moreover, this type of work has not been conducted in high-risk, socioeconomically disadvantaged Black individuals from urban communities or within a genetically informed framework that facilitates adjustment for shared genetic liability.

Method: The current study will recruit 464 self-identified Black adults who report a history of at least one traumatic event, current PTSD symptoms, and a recent binge or hazardous drinking from a larger trauma-exposed urban cohort. Through intensive, repeated EMA over six months, this study will use established PTSD-AUD comorbidity models as organizing frameworks to characterize sex-specific, within-person symptom dynamics. We will examine the temporal stability of these dynamics and explore how social drivers of health and unique and shared genetic risk for PTSD and AUD are associated with the maintenance and exacerbation of comorbid symptomatology over time.

Discussion: Study findings will provide valuable insight to guide targeted prevention and clinical treatment outcomes.

Rights

© 2026 The Authors

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Data Availability

Article states: "Data for this study will be submitted to the National Institute of Mental Health Data Registry (NDA) per NIH guidelines and will be available following the completion of the study, per reasonable request to the corresponding authors."

Original Publication Citation

Stinson, E. A., Lellapalli, S., Hawn, S. E., Merrill, N., Rappaport, L. M., Sheerin, C. M., Michopoulos, V., Bacanu, S. A., Peterson, R. E., Powers, A., & Amstadter, A. B. (2026). Advancing models of PTSD-AUD comorbidity: Protocol for a multimethod framework using genetics and ecological momentary assessment. European Journal of Psychotraumatology, 17(1), Article 2635214. https://doi.org/10.1080/20008066.2026.2635214

ORCID

0000-0001-8501-4169 (Hawn)

Additional Files
zept_a_2635214_sm3695.pdf (184 kB)
Supplemental Material
Download

Share

COinS