Posttraumatic Stress, Alcohol Use, and Alcohol Use Motives in Firefighters: The Role of Sleep Disturbance

Firefighters are at an elevated risk for posttraumatic stress symptomatology and alcohol use, with research demonstrating that individuals with posttraumatic stress may be more likely to use alcohol as a coping strategy. A behavioral mechanism of great clinical relevance to these associations is sleep disturbance. Thus, the current study examined associations among posttraumatic stress symptom severity, sleep disturbance, and alcohol use severity and alcohol use motives in a sample of 639 urban firefighters (93.6% male; Mage= 38.5, SD = 8.6). Structural equation modeling was employed to examine the study hypotheses, including: 1) posttraumatic stress symptom severity will predict alcohol use severity and alcohol use coping motives; 2) sleep disturbance will predict alcohol use severity and alcohol use coping motives; and 3) the interactive effect of posttraumatic stress symptom severity and sleep disturbance will predict alcohol use severity and alcohol use coping motives. These effects were not anticipated for other alcohol use motives (i.e., conformity, enhancement, social), and all effects were expected above and beyond the theoretically-relevant covariates of years in the fire department and occupational stress. Results demonstrated that posttraumatic stress symptom severity and sleep disturbance severity were significantly, positively associated with alcohol use severity and alcohol use motives. After accounting for covariates and main effects, the interaction of posttraumatic stress symptom severity and sleep disturbance was a significant predictor of alcohol use severity and alcohol use coping motives, but not other alcohol use motives. Clinical and research implications are discussed.