Caregiver Support Buffers Posttraumatic Stress Disorder Symptoms Following a Natural Disaster in Relation to Binge Drinking

Clinical Impact Statement The present study suggests that among adolescents exposed to a natural disaster, prior traumatic events and posttraumatic stress disorder (PTSD) symptoms are better predictors of adolescent binge-drinking behavior compared to natural disaster severity. Additionally, caregiver support buffered the effects of disaster severity on PTSD symptoms, but not the effects of prior trauma on PTSD symptoms, which highlights the protective role social support plays in decreasing psychopathology immediately following a natural disaster. Our results emphasize the importance of processing prior traumas as they are a stronger predictor of adolescent binge-drinking behavior, as well as providing caregiver support following exposure to a natural disaster. Objective: We investigate if posttraumatic stress disorder (PTSD) symptoms mediate the effects of disaster severity or prior trauma on binge drinking following disaster exposure and test if support from caregiver moderates the relation between disaster severity and PTSD symptoms as well as prior trauma and PTSD symptoms. Method: A population-based clinical trial used address-based sampling to enroll 1,804 adolescents and parents from communities affected by tornadoes in Missouri and Alabama. Data collection via baseline (averaging 8 months postdisaster), 4-month postbaseline, and 12-month postbaseline semistructured telephone interviews was completed between September 2011 and August 2013. Longitudinal analyses, testing the indirect effects of disaster severity and prior traumatic events on alcohol use through PTSD symptoms, as potentially moderated by support from caregiver, were conducted. Results: PTSD symptoms mediated the effect of prior trauma, but not disaster severity, on binge drinking. Specifically, those with more prior traumas reported more PTSD symptoms, which in turn increased risk for binge drinking. Support from caregiver moderated the effect of disaster severity, but not prior trauma, on PTSD symptoms. Specifically, the effect of disaster severity on PTSD symptoms was significant for adolescents with average or below-average caregiver support. Conclusion: Findings suggest that PTSD symptomatology is one mechanism by which prior trauma can impact binge drinking among adolescents following exposure to a natural disaster. Caregiver support can serve as a buffer for reducing PTSD symptomatology related to the severity of a natural disaster, which can decrease the likelihood of adolescent binge drinking.