Substance Use for Coping Predicts Posttraumatic Stress Symptom in Black and White Disaster Volunteers

Background: Despite burgeoning disaster research, longitudinal investigation on substance use for coping (SUC) with the collective traumatic event among student volunteers remains rare. Further, trauma researchers have emphasized the necessity for more findings concerning the long-term effects of risk factors (e.g., SU) and protective factors (e.g., personality strengths) that contribute to both traumatization and mental health in the aftermath. Few studies have used Bayesian structural equation modeling (Bayesian-SEM) that has advantages in small samples and dichotomized endpoints in disaster workers. This prospective study met the gap on using SUC and altruism to predict posttraumatic stress disorder (PTSD) in the follow-up among social work students who volunteered in the aftermath of a deadly hurricane.

Methods: A survey was conducted at three months (Wave-1) and six months (Wave-2) after hurricane Katrina and Rita (H-KR) (N=201) on social work student volunteers during deadly hurricanes. Standardized instruments were used to assess posttraumatic stress symptoms (PTSS), altruism, substance use for coping, and event-based factors in Wave-1 and PTSD in Wave-2. The R package blavaan (Merkle & Rosseel, 2015) was employed to estimate the hypothetical Bayesian-SEM concerning the role of Wave-1 SUC and altruism in Wave-2 PTSD. Substance Use for Coping was represented by a latent factor with two indicators.

Results: PTSD were identified in 18+% and ˷12% in Waves-1 and 2, respectively, without significant reduction. The initial estimation of Model 1 using the R blavaan package demonstrated a good fit to the data. Additionally, the modification index suggested that no theoretically plausible paths should be added to improve the model fit further. The final solution of Bayesian-SEM showed no direct overtime effect of SUC, but the indirect effects through the enhancing role of Waves-1 PTSS, on Wave-2 PTSD. Inconsistent with prior cross-sectional studies, there was no observed protection of peritraumatic positive emotions and no direct overtime effect of altruism was observed.

Conclusions and Implications: The findings underscore the significance of longitudinal post-disasters research. Given the new evidence on volunteers’ PTSD, substance use for coping in time of crises with limited resources needs more investigation for altruistic helpers. The lack of identified protective factors in social work volunteers has alarming future implications for theory, research, and practice in trauma intervention.