Posttraumatic stress disorder strengthens the momentary associations between emotion dysregulation and substance use: a micro-longitudinal study of community women experiencing intimate partner violence

Background and Aims A fast-growing body of literature linking emotion dysregulation to substance use has almost exclusively relied on cross-sectional designs and has generally failed to assess dysregulation stemming from positive emotions. The current study measured the momentary associations between both negative and positive emotion dysregulation and substance use, as well as the moderating role of posttraumatic stress disorder (PTSD). Design Micro-longitudinal momentary data were collected three times per day for 30 days using phone-based interactive voice recording. Setting Northeastern United States. Participants A total of 145 community women (M, age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances were recruited from 2018 until 2020. Measurements Momentary surveys assessed negative and positive emotion dysregulation and alcohol, drug, and cigarette use. PTSD diagnosis was derived from a structured diagnostic interview. Findings Between-person relations that remained significant after covariate adjustment and correction for multiple testing were found for negative emotion dysregulation and both number of drinks (internal rate of return [IRR] = 1.45; 95% CI = 1.07, 1.93; beta = 0.37) and drug use (OR = 3.78; 95% CI = 1.86, 7.69; beta = 1.33), and positive emotion dysregulation and number of cigarettes (OR = 1.40; 95% CI = 1.07, 1.82; beta = 0.34). Of six interactions tests, PTSD was only shown to moderate the within-person relation between positive emotion dysregulation and drug use, even after controlling for relevant covariates and adjusting for multiple testing (OR = 1.26; 95% CI = 1.04, 1.51; beta = 0.23), such that women experiencing intimate partner violence with versus without PTSD were more likely to use drugs when experiencing periods of elevated positive emotion dysregulation. Conclusions Women experiencing intimate partner violence with higher levels of negative dysregulation relative to others may use more alcohol and be more likely to use drugs. Women experiencing intimate partner violence with higher levels of positive dysregulation relative to others may use more cigarettes. Women experiencing intimate partner violence who also have posttraumatic stress disorder may be more likely to use drugs when experiencing momentary elevated levels of positive emotion dysregulation than those who do not also have posttraumatic stress disorder.