Traumatic Experiences and Reduced Alcohol Self-efficacy in Alcohol Dependent Inpatients: Attentional and Autonomic Mediators

ABS TRACT: Traumatic experiences and reduced alcohol self-efficacy in alcohol dependent inpatients: attentional and autonomic mediators Objective: Self-medication with alcohol has been documented among individuals exposed to chronic trauma who may be unable to resist urges to drink in high-risk situations. Persistent alcohol use can result in attentional bias (AB) toward alcohol cues and psychophysiological reactivity such as changes in cue-elicited heart rate variability (HRV). The present study tested the hypothesis that individual differences in alcohol AB and HRV mediate the association between lifetime exposure to traumatic events and alcohol-related selfefficacy among a sample of alcohol dependent adults in inpatient treatment. Method: This paper details a secondary data analysis from a sample of alcohol dependent adults (N = 58) who completed standardized psychosocial instruments, an affect-modulated cue reactivity protocol, and a spatial cueing task. Results: Path analyses indicated statistically significant direct effects of levels of lifetime trauma exposure on Low Frequency/High Frequency-HRV cue-reactivity, alcohol AB, and alcohol self-efficacy. A statistically significant indirect effect was found from lifetime trauma exposure to alcohol-related self-efficacy through alcohol AB. Conclusions: Results suggest that alcohol AB partially mediates the relationship between greater lifetime trauma exposure and reduced alcohol self-efficacy. Hence, alcohol dependent individuals with more extensive trauma histories may benefit from therapies aimed at increasing self-awareness and self-regulation of attentional and autonomic reactivity to prevent risk of relapse.