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Behavioral Economic Analysis of the Comorbidity of Alcohol Problems and Posttraumatic Stress: Findings From High-Risk Young Adults and General Community Adults

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Brian M. Bird at McMaster University
Brian M. Bird
Kyla L. Belisario at McMaster University
Kyla L. Belisario
James G Murphy at University of Memphis
James G Murphy
Sherry H Stewart at Dalhousie University
Sherry H Stewart
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Abstract

A behavioral economic reinforcer pathology model theorizes that alcohol problems are influenced by steep delay discounting, overvaluation of alcohol reinforcement, and low reinforcement from alcohol-free activities. Extending this account to the comorbidity of alcohol problems and posttraumatic stress disorder (PTSD), the present study tested the hypothesis that alcohol problems and PTSD symptom severity would interact and be positively associated with indicators from these three domains. High-risk emerging adults from North America (Study 1, n = 1,311, Mage = 22.13) and general community adults from Canada (Study 2, n = 1,506, Mage = 36.80) completed measures of alcohol problems, PTSD symptoms, delay discounting, alcohol demand, and proportionate alcohol-related reinforcement. Across studies, regression analyses revealed significant main effects of alcohol problems and PTSD symptoms in relation to selected reinforcer pathology indicators, but no significant interactions were present for delay discounting or proportionate alcohol-related reinforcement. Interactions were observed for alcohol consumption at $0 (intensity) and the rate of change in consumption across the demand curve (elasticity; Study 1) and for elasticity and maximum alcohol expenditure (Omax; Study 2), but not in the predicted directions. Higher synergistic severity was associated with lower alcohol reinforcing value in each case. These findings reveal expected relations between reinforcer pathology indicators and both alcohol problems and PTSD symptomatology in general but did not support the hypothesized synergistic relationship. The relation between alcohol problems and PTSD is more complex than predicted by existing extensions of the reinforcer pathology model, warranting further investigation.
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Behavioral Economic Analysis of the Comorbidity of Alcohol Problems
and Posttraumatic Stress: Findings From High-Risk Young Adults
and General Community Adults
Brian M. Bird
1, 2
, Kyla Belisario
1, 2
, James G. Murphy
3
, Sherry H. Stewart
4, 5
, and James MacKillop
1, 2
1
Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare Hamilton, McMaster University
2
Department of Psychiatry and Behavioural Neurosciences, McMaster University
3
Department of Psychology, University of Memphis
4
Department of Psychiatry, Dalhousie University
5
Department of Psychology and Neuroscience, Dalhousie University
A behavioral economic reinforcer pathology model theorizes that alcohol problems are influenced by steep
delay discounting, overvaluation of alcohol reinforcement, and low reinforcement from alcohol-free
activities. Extending this account to the comorbidity of alcohol problems and posttraumatic stress disorder
(PTSD), the present study tested the hypothesis that alcohol problems and PTSD symptom severity would
interact and be positively associated with indicators from these three domains. High-risk emerging adults
from North America (Study 1, n=1,311, M
age
=22.13) and general community adults from Canada (Study
2, n=1,506, M
age
=36.80) completed measures of alcohol problems, PTSD symptoms, delay discounting,
alcohol demand, and proportionate alcohol-related reinforcement. Across studies, regression analyses
revealed significant main effects of alcohol problems and PTSD symptoms in relation to selected reinforcer
pathology indicators, but no significant interactions were present for delay discounting or proportionate
alcohol-related reinforcement. Interactions were observed for alcohol consumption at $0 (intensity) and the
rate of change in consumption across the demand curve (elasticity; Study 1) and for elasticity and maximum
alcohol expenditure (O
max
; Study 2), but not in the predicted directions. Higher synergistic severity was associated
with lower alcohol reinforcing value in each case. These findings reveal expected relations between reinforcer
pathology indicators and both alcohol problems and PTSD symptomatology in general but did not support
the hypothesized synergistic relationship. The relation between alcohol problems and PTSD is more complex
than predicted by existing extensions of the reinforcer pathology model, warranting further investigation.
Public Health Significance
Understanding the psychological mechanisms underlying the comorbidity of alcohol problems with
posttraumatic stress disorder (PTSD) is an important area of inquiry. This study applied the behavioral
economic reinforcer pathology model to this question in two samples, revealing significant individual
alcohol and PTSD associations but not the predicted synergistic relationship. Indeed, in some cases,
significant results in direct opposition to the prediction suggested further research on the application of
reinforcer pathology theory to comorbid PTSD–alcohol problems is needed.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This article was published Online First August 29, 2024.
Jin H. Yoon served as action editor.
James MacKillop https://orcid.org/0000-0002-8695-1071
James MacKillop is a principal and senior scientist in Beam Diagnostics,
Inc. and has served as a consultant to Clairvoyant Therapeutics, Inc. Study 1
was preregistered with the Open Science Framework and can be accessed at
https://osf.io/5ardv/?view_only=0e0b86fdfdaf4df0b5fe900ab218365a.
The authors have no conflicts of interest to disclose. This work was funded
by Grants PJT 148703 and MFE 181842 from the Canadian Institutes of
Health Research awarded to James MacKillop and Brian M. Bird and by
Grant R01AA024930 from the National Institute on Alcohol Abuse and
Alcoholism awarded to James G. Murphy and James MacKillop. This work
was also supported by the Peter Boris Chair in Addictions Research and a
Canada Research Chair in Translational Addiction Research (CRC-
2020-00170).
Brian M. Bird played a lead role in writing–original draft and writing–
review and editing, a supporting role in funding acquisition, and an equal role
in conceptualization, formal analysis, and visualization. Kyla Belisario
played a lead role in data curation and software, a supporting role in writing–
review and editing, and an equal role in formal analysis and visualization.
James G. Murphy played a lead role in conceptualization, funding acquisition,
and methodology and a supporting role in writing–review and editing. Sherry
H. Stewart played a supporting role in writing–review and editing and an
equal role in conceptualization and supervision. James MacKillop played
a lead role in conceptualization, funding acquisition, methodology, and
supervision and a supporting role in writing–review and editing.
Correspondence concerning this article should be addressed to Brian M.
Bird, Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare
Hamilton and McMaster University, 100 West 5th Street, Hamilton, ON
L8N 3K7, Canada. Email: brian.bird33@gmail.com
Experimental and Clinical Psychopharmacology
© 2024 American Psychological Association 2024, Vol. 32, No. 6, 639–651
ISSN: 1064-1297 https://doi.org/10.1037/pha0000735
639
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