Rumination and Self-Medication Among Women with Posttraumatic Stress and Alcohol Use Disorders

Rumination and Self-Medication Among Women with Posttraumatic Stress and Alcohol Use Disorders by Dee Ann D. Lizarraga MS, Walden University, 2014 MA, Argosy University, 2011 BS, Francis Marion University, 1985 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Clinical Psychology Walden University November 2018 Abstract Women with posttraumatic stress disorder (PTSD) often develop alcohol use disorders (AUD) resulting from the use of alcohol to self-medicate from negative affect. Research supports the relationship between comorbid PTSD and AUD, and studies with women additionally identify the role of rumination, or excessive thinking about distress and its causes, as a precipitating aspect leading to self-medication. Female-based data is sparse, however, regarding specific thought patterns and factors which trigger the need to selfmedicate with alcohol. Numerous researchers have studied the relationship between stress, anxiety, and alcohol use, although, there exists a need for qualitative studies providing thick, rich information. Applying the self-medication model and rumination theory, the purpose of this study was to use a transcendental research framework as a lens to explore and describe the phenomenon of how women with comorbid PTSD and AUD make sense of their dual disorder. Qualitative data were gathered from in-depth interviews of 12 women who participated in Alcoholics Anonymous groups in a large Southeastern city. The women collectively described their lived experience with theWomen with posttraumatic stress disorder (PTSD) often develop alcohol use disorders (AUD) resulting from the use of alcohol to self-medicate from negative affect. Research supports the relationship between comorbid PTSD and AUD, and studies with women additionally identify the role of rumination, or excessive thinking about distress and its causes, as a precipitating aspect leading to self-medication. Female-based data is sparse, however, regarding specific thought patterns and factors which trigger the need to selfmedicate with alcohol. Numerous researchers have studied the relationship between stress, anxiety, and alcohol use, although, there exists a need for qualitative studies providing thick, rich information. Applying the self-medication model and rumination theory, the purpose of this study was to use a transcendental research framework as a lens to explore and describe the phenomenon of how women with comorbid PTSD and AUD make sense of their dual disorder. Qualitative data were gathered from in-depth interviews of 12 women who participated in Alcoholics Anonymous groups in a large Southeastern city. The women collectively described their lived experience with the phenomenon as an internally-focused strategy premised on the notion of a “Higher Power. ” They reported using this strategy to manage thoughts, feelings, and behaviors which triggered negative self-assessment and the need to self-medicate with alcohol. This research contributes to the literature by offering a more detailed understanding of comorbid PTSD and AUD. Positive social change can be achieved with a better understanding of the etiology of female trauma and the factors that trigger alcohol relapse in women with PTSD. Rumination and Self-Medication Among Women with Posttraumatic Stress and Alcohol Use Disorders by Dee Ann D. Lizarraga MS, Walden University, 2014 MA, Argosy University, 2011 BS, Francis Marion University, 1985 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Clinical Psychology Walden University November 2018 Dedication This work is dedicated to the brave women who took part in this study. Their voices can help us better understand the relationship between abuse and alcohol use. Let their courage, strength, and fortitude expedite the development of treatment programs which can better serve a female population with this dual disorder. Acknowledgments First, and foremost, thank you God for guiding me on this journey, even though at times I may have questioned the path I was on. Thank you so much to my husband, Joshua, who supported me through this entire process and encouraged me to push forward. Without him, this would not have been possible. Thank you to my son, Joshua, and his wife, Allison, for giving me a reason to finish. Last of all, thanks to Chi Chi and Nala who licked the tears from my eyes when the women’s stories made my heart ache.