The direct & indirect links from facets of childhood trauma to arousability, impaired control, alcohol use, & alcohol-related problems.

Hyper-arousal theory presumes that experiencing trauma can increase one’s sense of fight or flight responses or generalized sense of arousability (Riemann et al., 2010). While this theory has been examined in studies regarding insomnia (e.g. Schwandt et al., 2013) it has yet to be examine with dysregulated drinking outcomes such as impaired control over alcohol use. Impaired control over alcohol use (IC) reflects drinking beyond one’s own self-proscribed limits for one’s own drinking behaviors (Heather et al., 1993). According to multiple review papers on the topic (Leeman et al., 2012; 2014), IC is an understudied topic regarding alcohol use disorders (AUDs). Thus, we sought to explore a pathway from facets of childhood trauma (emotional, physical, & sexual abuse, & neglect) versus a supportive family to arousability to drinking outcomes (i.e. IC, alcohol use, & alcohol-related problems). Method: We fit a multiple-group structural equation model with 835 (368 women/ 467 men) university student volunteers. As our model failed the overall invariance test, χ2Δ (20 df) = 55.788, p < .001, we allowed our hypothesized model to moderate on sex. Results: The direct link from sexual abuse to both IC and alcohol-related-problems was stronger for men than women. Emotional abuse was directly linked to higher levels of arousability among women, whereas an emotionally supportive family was related to lesser degrees of arousability among men. Impaired control mediated the indirect link between higher levels of arousability and alcohol use for both sexes. Impaired control also mediated the indirect link between physical neglect and alcohol-related problems among both sexes. Higher levels of emotional abuse were indirectly linked to both more alcohol use & problems through increased arousability and in turn, more IC among women. Higher levels of sexual abuse were indirectly linked to more alcohol problems through higher degrees of impaired control among men. Conclusions: We found evidence in favor of the Hyper-arousability Theory regarding dysregulated drinking with a direct link between arousability and IC. While physical neglect appears to affect both sexes drinking behaviors, emotional abuse may play a stronger role for women than men, while sexual abuse may play a stronger role among men.