Alcohol Use among Trauma-Exposed College Students: Associations with Sleep and Distress Tolerance

Alcohol misuse is a public health concern among undergraduate students, particularly those who report trauma exposure. Sleep disturbance, a prevalent issue for undergraduate populations, is related to heightened alcohol use severity and coping-motivated alcohol use. Distress tolerance (DT) is a transdiagnostic factor, defined as the perceived ability to withstand negative emotional states, that may exacerbate associations between sleep disturbance and alcohol use by amplifying coping-oriented alcohol use intended to manage negative emotional states. The present study examined the indirect effect of sleep disturbance on alcohol use through alcohol-related coping motives at differing levels of DT, after controlling for gender, trauma load, past month substance use, and conformity, enhancement, and social drinking motives. Data were collected as part of a larger, survey-based study examining stress and health-related behaviors among college students. Participants included 2066 trauma-exposed, undergraduate students who endorsed lifetime alcohol consumption (77.8% female; 49.8% white; Mage= 22.3 ± 5.0 years). Sleep disturbance was significantly associated with alcohol use severity indirectly via coping-motivated alcohol use (b = .0740, SE = .0110, CI [.0539, .0971]), replicating past work. As hypothesized, the model was not significant for other drinking motives (i.e., enhancement, social, and conformity). However, when DT was added as a moderator to the model, the results were not significant (b = .0002, SE = .0006, CI [-.0011, .0014]. Further research examining the interrelatedness of trauma, sleep disturbance, coping-motivated alcohol use, and DT can inform evidence-based prevention and intervention for college students.