Eysenck’s (1967) biological model of personality suggests traits relate to meaningful functioning and structural variations regarding cortical and limbic brain regions. Neuroticism denotes the tendency to experience negative affect (i.e. anxiety, worry, tension, irritability) more frequently than others do (Eysenck 1956). Patock-Peckham & Lopez, 2010). Individuals higher on neuroticism have lower thresholds for a fight or flight response to stressors (Xin et al., 2017). Childhood trauma is associated with increased expression of neurotic traits in an alcohol dependent sample (Schwandt et al, 2013). However, to date, it remains unexplored in the existing literature as to whether or not neuroticism mediates any indirect links from facets of childhood trauma (e.g. emotional, sexual, physical, or neglect) or a supportive family on dysregulated drinking. Impaired control over alcohol use reflects drinking larger amounts and for greater periods than one originally intended (Heather et al., 1993). We fit a multiple-group structural equation model with 937 (465 women/472 men) university student volunteers on a model from trauma facets to alcohol use and problems with neuroticism and impaired control as potential mediators. Results: We found that higher levels of emotional abuse were directly linked to more neurotic symptoms among both cisgender sexes. In addition, we found that higher degrees of a supportive family were directly linked to less neuroticism among women only. Interestingly, neuroticism was directly linked to less alcohol use. Yet, when impaired control was a mediator of the neuroticism to alcohol use pathway, alcohol use increased. We also found that higher levels of supportive family were indirectly linked to less neuroticism and in turn, less impaired control over drinking among women only. However, higher levels of emotional abuse were indirectly linked to more alcohol-related problems through both more neuroticism and impaired control for both genders. Our results support that impaired control may be a key mediating mechanism to internalizing traits such as neuroticism in the alcohol use quantity/frequency pathway. Further, our results suggest that emotional abuse may be an important therapeutic target of intervention for those with comorbid internalizing and alcohol use disorders. NIH/NIAAA K01AA024160-01A1; Burton Family Foundation FP11815 to Julie Patock-Peckham.

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.