Relationship between Trauma Exposure and Alcohol Use Disorder Among African American Emerging Adults

Background and Purpose: Alcohol use disorder is considered a major public health problem among young people. Youth transitioning into adulthood have the highest rates of alcohol and substance abuse (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). Exposure to traumatic experience is often an overlooked factor related to alcohol abuse. Prior studies have mainly examined the role of adverse childhood experiences as contributors to posttraumatic stress disorder and alcohol use disorders (Brady & Back 2012; Cross, Crow, Powers, & Bradley, 2015). However, little is known about the effect of lifetime traumatic events experienced by young African Americans who abuse alcohol and the relationship between specific types of trauma (e.g., community violence, indirect trauma) and alcohol use disorder. The purpose of the current study is to examine the relationship between each type of trauma exposure and the severity of alcohol use among African American emerging adults.

Methods: A cross-sectional survey was used to study a sample of 60 African Americans emerging adults from multiple community centers in a large U.S. city in 2017. The survey collected demographic information, trauma exposure, alcohol use, and mental health issues. Participants’ trauma exposure was measured using the 17 items Life Events Checklist (LEC) for DSM-5. Responses were combined to create a continuous score (mean=18.2, SD=2.0). Alcohol use was assessed using the 10-item Alcohol Use Disorders Identification Test (AUDIT). Responses were summed to a composite score (mean=15.6, SD=3.5). Multivariate analyses were conducted to explore the relationship between childhood and lifetime trauma and alcohol use.

Results: The average age of the participants was 19.2 years (SD = 2.3) and over half of them (66.7%) were male. Some of them (50.4%) received high school education and a few of them (38.6%) had less than high school education. A majority of them (79.9%) were unemployed and some of them (16%) had children. Multivariate analyses showed that having a history of childhood maltreatment trauma was significantly associated with an increased drinking level (β = .23, p < .01). In addition, being exposed to community violence was also significantly associated with a heavier alcohol use (β = .15, p < .01). Risk factors contributing to alcohol use included being a male, a lower level of family income, and having a mental illness. Spirituality was a significant protective factor to their alcohol use.

Conclusions and Implications: The current study adds to the literature by examining the relationship between different types of trauma exposure and the severity of alcohol use among African American emerging adults. Examining the impact of each type of trauma on drinking is beneficial to better understand the root cause of alcohol use disorder in this population and tailor culturally competent treatments. The study findings showed that lifetime traumatic events such as community violence had a significant relation with alcohol use. The effect of community violence was as significant as the effect of childhood trauma on alcohol use. The findings provide implications to address violence in community when design innovative trauma-informed care to enhance alcohol treatment outcomes.