The Longitudinal Buffering Effects of Resilience on Alcohol Use Outcomes

Clinical Impact Statement The present study shows that psychiatric resilience is an important protective factor against the development of alcohol use disorder symptoms after trauma exposure during the college years. Prevention and intervention efforts should thus focus on preventing college onset trauma exposure, and enhancing levels of resilience toprotect against alcohol misuse. Objective: Traumatic events (TE) are a risk factor for alcohol use disorder (AUD). Resilience may be protective of the effects of TE exposure, but few studies have longitudinally tested the buffering hypothesis. Thus, the present study aimed to fill this gap. Method: Participants (N = 6,015) were from a longitudinal investigation into substance use and health outcomes at a large, urban university. Participants completed self-report measures on precollege internalizing symptoms and lifetime trauma load. Resilience was calculated as a quantitative variable. At each of the follow-up assessments, participants reported on past month consumption, AUD symptoms, and new onset TEs. Longitudinal path modeling was used to test interactions. Results: Higher new onset TE load was associated with greater AUD symptoms, and higher consumption at one time-point. Results demonstrate a significant main effect of resilience at Y1S and Y3S, and a significant interaction between resilience and new onset TE at the last time-point, whereby higher levels of new onset TE were associated with higher levels of AUD symptoms at low (beta = .19, p < .001), and average (beta = .20, p = .001) levels of resilience. This effect was attenuated at high levels of resilience (beta = .07, p = .051). No significant main nor interaction effects of resilience on consumption were found. Conclusions: Findings suggest resilience as an important protective factor in relation to the development of AUD symptoms after exposure to a TE, though perhaps less so in relation to consumption. Findings are consistent with prior work demonstrating that AUD symptoms are more clinically relevant than consumption in this population.