Temporal relations between alcohol use, posttraumatic stress disorder, and internalizing symptoms during the COVID-19 pandemic: An ecological momentary assessment investigation.

Abstract

Objective: COVID-19 is a collective stressor associated with both increased mental health symptoms and increased frequency of alcohol use. These increases highlight the need for investigations into the functional relationships between traumatic stress symptoms and alcohol use in the wake of the pandemic. This study sought to use ecological momentary assessment to examine the temporal association of posttraumatic stress disorder (PTSD) with alcohol use during the COVID-19 pandemic.

Method: Participants were 21 students (M_age = 21.0; 86% female, 23.9% White) from a large, mid-Atlantic public university. Ecological momentary assessment data on PTSD symptoms, internalizing psychopathology, affect, and alcohol consumption were collected via twice daily surveys for a 14-day period.

Results: Increased negative affect predicted an increase in alcohol consumption at the next assessment. Increased alcohol consumption predicted increased subsequent negative affect, anxiety symptoms, and depressive symptoms. Findings did not support a relationship between PTSD symptoms and alcohol consumption in either direction.

Conclusions: Results suggest a bidirectional, cyclical relationship between alcohol consumption and internalizing psychopathology broadly, rather than PTSD specifically, during the pandemic. Interventions for alcohol consumption on college campuses may benefit from targeting internalizing symptoms, such as through facilitating the development of adaptive coping strategies. (PsycInfo Database Record (c) 2025 APA, all rights reserved).