Posttraumatic Stress, Alcohol Use, and Alcohol Use Motives among Firefighters: The Role of Distress Tolerance

Firefighters represent a unique, vulnerable population at high risk for alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) symptomatology due to the high rates of occupational exposure to traumatic events. To inform specialized alcohol use interventions for firefighters, it is important to understand relevant malleable cognitive-affective factors related to PTSD and AUD symptoms. Distress tolerance (DT), defined as the perceived ability to withstand negative emotional states, is one promising factor relevant to this domain. The current study aimed to examine the moderating role of DT in the association of PTSD symptom severity with alcohol use severity and motives. It is hypothesized that, among firefighters with higher levels of PTSD symptoms, lower levels of DT will be related to more severe alcohol use and greater coping-oriented alcohol use motives but no other use motives. Participants included 652 trauma-exposed firefighters (93.3% male; Mage = 38.7 years, SD = 8.6) who endorsed lifetime (ever) alcohol use. A series of regression analyses was conducted using PROCESS v3.1 for IBM SPSS version 25.0. Covariates included romantic relationship status, number of years in the fire service, occupational stress, and trauma load (i.e., number of traumatic event types). For analyses examining alcohol use motives, alcohol consumption was included as an additional covariate. The interactive effect of PTSD symptom severity and DT was significantly associated with coping-oriented alcohol use motives (R2 = .023, B = -.001, p<.001) but no other alcohol-related outcomes. This is the first study to concurrently examine these variables among firefighters. This line of inquiry will have great potential to inform intervention efforts for this vulnerable, understudied population.