Posttraumatic Stress, Alcohol Use, and Alcohol Use Motives Among Firefighters: The Mediating Role of Anxiety Sensitivity



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Firefighters are frequently exposed to high-risk, potentially life-threatening events, and as a result, they are vulnerable to developing posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). The current study aimed to examine the mediating role of anxiety sensitivity (AS; fear of anxiety-related sensations) in the association of PTSD symptomology with alcohol use and alcohol use motives among a large sample of firefighters. It was hypothesized that heightened PTSD symptom severity would be indirectly associated with alcohol use and alcohol use coping motives, specifically, through high AS. This study is a secondary analysis of data from a larger study examining stress and health behaviors among firefighters. Participants were comprised of 652 urban firefighters who endorsed DSM-5 PTSD Criterion A trauma exposure and lifetime alcohol use. Firefighters completed an online questionnaire battery. Descriptive statistics and bivariate correlations were calculated for all study variables. A series of path analyses were conducted and regression coefficients for each hypothesized path were evaluated. Covariates included number of years in the fire service and trauma load (i.e., number of traumatic event types experienced). After accounting for covariates, AS partially mediated the association between PTSD symptom severity and alcohol use coping motives (indirect effect = .054, 95% CI [.006, .110]), conformity motives (indirect effect = .095, 95% CI [.034, .161]), and social motives (indirect effect = .054, 95% CI [.008, .109]). However, AS did not significantly mediate the relationship between PTSD symptom severity and enhancement motives (indirect effect = .047, 95% CI [-.002, .105]) or alcohol use severity (indirect effect = .026, 95% CI [-.026, .082]). Results indicate that AS reduction techniques may be effective in PTSD/AUD interventions for firefighters. Clinical and research implications are discussed.



Trauma, Post-traumatic stress disorder (PTSD), Post-traumatic stress disorder (PTSD), Anxiety sensitivity, Alcohol, Firefighters