Markers of Negative Emotionality in Individuals With Comorbid Alcohol Use Disorder and Post-Traumatic Stress Disorder: Role of Childhood Trauma

Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are characterized with heightened negative emotionality (NE) and are frequently comorbid. However, little research has investigated NE in individuals with comorbid AUD/PTSD. We compared psychological and biological markers of NE phenotypes, and alcohol-related outcomes between individuals with AUD with and without PTSD, and healthy controls. Additionally, we evaluated whether childhood trauma severity moderated these relationships. Participants [N = 1292; healthy controls (HC): n = 502 (38.9%); AUD only: n = 610 (47.2%), and AUD/PTSD (CMB); n = 180 (13.9%)] enrolled in the National Institute on Alcohol Abuse and Alcoholism Natural History Protocol underwent clinical, biological and behavioural phenotyping that included psychiatric diagnoses, markers of negative emotionality and allostatic load, alcohol use behaviour, and history of childhood trauma. The CMB group had the most severe alcohol use and childhood trauma history. Psychological NE were the most dysregulated among the CMB group. Biological markers of NE were also dysregulated among the AUD and CMB group, where they displayed greater resting heart rate, diastolic blood pressure and HDL cholesterol relative to HC. Greater childhood trauma severity was associated with greater psychological NE. However, the childhood trauma did not moderate any relationship between diagnosis and NE phenotypes. These results highlight important differences in NE, childhood trauma and alcohol use in individuals with AUD with and without comorbid PTSD. Targeting NE and alcohol-related behaviours is critical in effective treatment of individuals with comorbid AUD/PTSD.

Trial Registration: ClinicalTrials.gov: NCT02231840.