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Published in final edited form as: J Subst Use Addict Treat. 2023 Dec 14;159:209263. doi: 10.1016/j.josat.2023.209263

The relationship between discrimination, alcohol use severity, and PTSD symptoms among Latinx heavy drinkers

Christina S Lee 1, Tessa Nalven 2, Audrey Hai 3, Miguel Pinedo 4, Victoria Lopez 5, Melanie Morris 6, Jorge Delva 7, Miguel Cano 8
PMCID: PMC10947868  NIHMSID: NIHMS1953287  PMID: 38103830

Abstract

Introduction:

Discrimination is linked to alcohol use severity among Latinx adults, who also show high prevalence rates of PTSD compared to non-Latinx adults. We know little about whether PTSD symptoms affects the relationship between discrimination and alcohol use severity. We hypothesized that the association between discrimination and alcohol use severity might differ by level of PTSD symptom severity.

Methods:

This is a secondary cross-sectional analysis of data collected at baseline from a completed randomized clinical trial testing the relative efficacy of a culturally adapted motivational interview designed to address discrimination and drinking behavior against an unadapted motivational interview for Latinx adults. Eligible participants screened positive for the NIAAA Single Alcohol Screening Question for heavy drinking days, identified as Latinx, and were 18–65 years old. We assessed the Everyday Discrimination Scale, Primary Care PC-PTSD screener, Alcohol Use Disorder Identification Test, and the Short Acculturation Scale for Hispanics. The study analyzed the main and interactive effects of discrimination and PTSD symptoms on alcohol use severity, while controlling for age, sex, household income, and acculturation.

Results:

After controlling for covariates in model 2, the interaction of discrimination and PTSD symptoms was significantly related to alcohol use severity. Simple slopes analysis indicated that discrimination was positively related to alcohol use severity among those with high (1 SD above the mean) but not low (1 SD below the mean) levels of PTSD symptoms.

Conclusions:

Evidence suggests that the experiences of discrimination were associated with alcohol use severity among those who reported more PTSD symptoms. Specifically, discrimination may have a stronger effect on alcohol use severity among Latinx adults who report more PTSD symptoms. Screening Latinx adults for heavy drinking days, discrimination, and PTSD symptoms is clinically important. Culturally adapted alcohol interventions that target discrimination may be particularly effective for Latinx individuals with more PTSD symptoms.

Keywords: PTSD symptoms, Alcohol use severity, Discrimination, Latinx

1. Introduction

1.1. Overview

Latinx1 adults constitute the largest racial/ethnic group in the United States and have the greatest growth in the past 10 years (Jones et al., 2021). Alcohol is one of the most commonly used substances among Latinx adults (Vaeth et al., 2012). Latinx adults experience health disparities related to alcohol use, including higher rates of alcohol use disorders and cirrhosis (Ortega et al., 2015). Discrimination increases the risk for alcohol use disorders among Latinx adults (Glass et al., 2020a; Ornelas et al., 2011; Otiniano-Verissimo et al., 2013, 2014a). An analysis of the cross-sectional NESARC (2012–2013) data measured the context of the respondent’s discrimination experience. Findings documented that the risk for alcohol use disorders among Latinx individuals was proportionately higher as a function of the number of situations in which discrimination had been experienced (Glass et al., 2020a). Further, there is growing evidence to support the idea that exposures to discrimination sometimes involves physical violence and intimidation that contributes to the development of posttraumatic stress symptoms or PTSD among individuals (Chavez-Dueñas et al., 2019; Comas-Díaz et al., 2019; Kilpatrick et al., 2013; Salas et al., 2013). Indeed Latinx adults show higher prevalence rates of PTSD compared to non-Latinx adults (Alcántara et al., 2013; Galea et al., 2004; Himle et al., 2009; Marshall et al., 2009; Ramos et al., 2017; Sibrava et al., 2019). However, little is known about whether PTSD affects the relationship between discrimination and alcohol use severity. We hypothesized that the association between discrimination and alcohol use severity might differ by level of PTSD symptoms.

1.2. PTSD symptoms and alcohol use severity among Latinx adults

Among Latinx adults, PTSD symptoms have been associated with alcohol use severity. One study of Mexican American adolescents recruited from a health maintenance organization (n=110) revealed that those with severe posttraumatic stress symptoms engaged in more risky behavior, such as increased alcohol and drug use (Flores et al., 2010a). Similarly, a longitudinal study of Latinx college students found that those who experienced racial/ethnic discrimination were at increased risk for developing both posttraumatic stress symptoms and alcohol misuse (Cheng & Mallinckrodt, 2015). Among Latinx college students, an indirect effect was found for PTSD symptom severity such that people with elevated PTSD symptoms reported drinking to reduce anxiety or to tolerate distress (McGrew et al., 2023). Ehlers et al. (2016) recruited n=614 Mexican American individuals (18–30 years old), who were mostly second generation from the community using a mailing list. That study administered participants the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), a fully structured poly-diagnostic interview that generated diagnoses according to DSM-IV criteria. The study found a heightened risk for PTSD and alcohol dependence in this sample, with preliminary evidence suggesting that alcohol dependence occurred after PTSD.

1.3. Study hypotheses

In our prior work we created a Culturally Adapted Motivational Interview (CAMI) to specifically target experiences of stigma and discrimination in Latinx adults who screened positive for heavy drinking days and tested CAMI in a randomized clinical trial (Lee et al. 2019). In this trial, we tested a measure of everyday discrimination as a treatment moderator and found that among Latinx adults who met criteria for heavy drinking, those who experienced higher levels of discrimination reported significantly better outcomes after receiving the CAMI (Lee et al., 2019). In the current study, we explore the potential moderating effects of PTSD symptoms on alcohol use severity in a sample of Latinx adults, nearly all of whom had experienced discrimination and were enrolled in the CAMI trial. The study entered age as a covariate because time in the United States may result in more frequent exposures to discrimination or PTSD (Perez-Rodrigues et al., 2014). We entered sex as a covariate because of the differences in drinking between males and females who are Latinx (Banta et al., 2014; Cook & Caetano, 2014; Vazquez et al., 2023). Household income was entered as a covariate because higher income might buffer against the harmful effects of discrimination, presumably by providing more resources (Cook & Caetano, 2014). The study entered acculturation as a covariate because it is thought to change to more of a heavy drinking pattern on weekends (Lee et al., 2006) or to have a positive association with alcohol consumption (Zemore, 2005).

2. Materials and methods

2.1. Participants and procedures

Between September 2013 and November 2016, the study recruited participants from Boston and surrounding areas using flyers posted on buses, the subway, and in free local English and Spanish newspapers for a randomized clinical trial (Lee et al., 2019). Research assistants screened potential participants in person or by phone and scheduled eligible participants for a baseline visit. Inclusion criteria: adults who identified as Hispanic/Latinx, aged 18–65, who screened positive for heavy drinking days (≥ 4/5 drinks (female/male) in a day (Single Item Alcohol Screening Question, n.d.), at least twice a month, and who were not in any alcohol treatment. Exclusion criteria: active drug use (≥ 4 times/month, excluding marijuana use), active psychotic symptoms, and evidence of cognitive impairment (e.g., being unable to understand informed consent). Research Assistants obtained informed consent prior to the baseline assessment, for which participants received $75 in gift cards. The University Institutional Review Board approved all procedures and the Clinical Trials Registration is #01996280.

This is a secondary cross-sectional analysis of data collected at baseline from the trial testing the relative efficacy of a culturally adapted motivational interview against an un-adapted motivational interview delivered to Latinx adults who screened positive for heavy drinking days.2 We added a measure of PTSD symptoms at baseline after the study began to have fewer participants (n=186) than were enrolled in the clinical trial (n=296). In the current study participants completed all the variables (n=186).

2.2. Measures

Demographics included questions referring to age, self-identified sex (male or female), and household income (1 = less than $15,000, 2 = $15,001–30,000; 3 = $30,001–45,000; 4 = $45,001–60,000; 5 = $60,001–75,000; 6 = $75,001–90,000; 7 = $90,001/above).

Discrimination was measured by the Everyday Discrimination Scale (D. R. Williams et al., 1997) and consists of 8 items asking about discrimination experienced in different contexts. The study recorded responses on a 5 item Likert scale (0 = Never, 5 = Almost every day; maximum score 40). We summed these answers as a total score, with higher numbers indicating greater frequency of discrimination experiences. The Cronbach’s alpha for = .87.

PTSD Symptoms were measured by the 4-item Primary Care PC-PTSD Screen (Prins et al., 2003) designed to detect an individual’s risk of PTSD in busy clinical settings. The the PC-PTSD captured four underlying empirically derived factors specific to the PTSD construct (i.e., not overlapping with psychological distress): re-experiencing, avoidance, hyperarousal, and numbing (Asmundson et al., 2000; Foa et al., 1995; Prins et al., 2003; Simms et al., 2002). Participants gave responses (Yes = 1, No = 0) to four symptoms associated with PTSD and the four items were added to create a total score (Range: 0–4) with higher scores indicating more PTSD symptoms. We used the PC-PTSD screener criteria (i.e. scoring a 3 or more) to identify a positive screen for PTSD (Prins et al., 2003). The Cronbach’s alpha = .85.

Short Acculturation Scale for Hispanics (Marin et al., 1987) is a 12-item scale where higher scores reflect higher acculturation levels (Ellison et al., 2011; Marin et al., 1987; Vella et al., 2011). For the 12 items, the study calculated a total score (total range 12–60). The study recorded responses on a 5 point Likert scale. For items reflecting language preference, the anchors were (1 = Only Spanish, 2 = More Spanish than English, 3 = Both equally, 4 = More English than Spanish, 5 = Only English). For items reflecting behavioral preferences, e.g., social gatherings, the study used the anchors (1 = All Latinos/Hispanics, 2 = More Latinos than Americans, 3 = About half and half, 4 = More Americans than Latinos, 5 = All Americans). The Cronbach’s α = .85.

The Alcohol Use Disorder Identification Test (AUDIT), a 10-item screening tool, assessed for alcohol use severity such that higher scores indicated greater severity of alcohol use (Saunders et al., 1993). A score of 8 or above (6 or above for females) indicates hazardous drinking, or a pattern of drinking that increases the risk of physical and social consequences for the user. An AUDIT score of (> 15 for men, >13 for women) indicates probable risk for alcohol dependence or severe alcohol use disorder (Saunders et al., 1993).

2.3. Analytic strategy

In the current study, we conducted analyses in IBM SPSS Statistics v.27. The study examined frequencies, descriptive statistics, and bivariate correlations to assess for assumptions of normality, homoscedasticity, and multicollinearity (Harlow, 2014; Tabachnick & Fidell, 2019). The study team used two linear regression models to examine variables associated with alcohol use severity. Model 1 tested the main effects of discrimination and PTSD symptoms for alcohol use severity while controlling for the effects of age, sex, household income, and acculturation. In model 2, the study analyzed main and interactive effects of discrimination and PTSD symptoms on alcohol severity using model one of the SPSS PROCESS macro (Hayes, 2018), while controlling for the effects of age, sex, household income, and acculturation. The PROCESS macro uses bootstrapping and ordinary least squares regression to estimate model coefficients, and non-binary predictor variables were mean centered prior to the construction of the interaction term (Hayes, 2018). Bootstrapping was done with 5,000 random samples generated from the observed covariance matrix to estimate significance values and bias-corrected 95% confidence intervals (CIs). The study used listwise deletion to handle missing data. Significant interactions were followed up with simple slopes analyses and differences in regression slopes were plotted for high (one SD above the mean) and low (one SD below the mean) levels of PTSD symptoms.

3. Results

3.1. Participants

A total of n=186 participants completed the PTSD measure. For household income, the study had n=1 with missing data. Participants were 40.3% female (n = 75) and 59.7% male (n = 111) and had a mean age of 39.8 years (SD = 12.4). 44.1% (n = 82) were born in the United States and 55.9% (n = 104) were foreign born. Participants reported living in the U.S. on average over 20 years, an average yearly household income of below $30,000, and more than half were not employed full-time (57.0%). The average score (M = 16.5, SD = 9.0) for the Alcohol Use Disorders Identification Test (AUDIT) exceeded the clinical cut-point (> 15 for men, >13 for women) indicating probable risk for alcohol use disorder (Lee et al., 2019). The mean acculturation score was 37.8 (SD = 10.1), indicating a highly acculturated sample, i.e., that many individuals in the study could speak English as well as Spanish. Approximately 91.4% of the sample reported discrimination and 37.6% of the sample screened positive for PTSD.

Descriptive analyses revealed that the primary variables of interest were approximately normally distributed based on established guidelines that absolute values of skewness > 2 and kurtosis > 4 indicate non-normality (Kim, 2013; West et al., 1995). See Table 1 for all descriptive statistics and bivariate correlations among discrimination, PTSD symptoms, alcohol severity, and covariates. Bivariate correlations revealed significant positive associations between discrimination and PTSD symptoms (r = .35, p < .001), discrimination and alcohol use severity (r = .33, p < .001), and PTSD symptoms and alcohol use severity (r = .23, p = .001).

Table 1.

Means, Standard Deviations, and Pearson Correlation Among Study Variables of Interest (n = 296)

1 2 3 4 5 6 7
1. Sex (male) -
2. Age 0.062 -
3. Household Income 0.096 −0.329** -
4. Acculturation −0.065 −0.202** 0.161** -
5. Discrimination 0.145* −0.002 −0.087 0.092 -
6. PTSD Symptoms −0.051 0.138 −0.201** −0.019 0.348** -
7. AUDIT 0.104 0.250** −0.281** −0.116 0.295** 0.225** -
M (SD) - 39.79 (12.42) - 37.84 (10.08) 10.44 (7.68) 1.70 (1.63) 16.47 (8.96)
Range - 19–65 - 12–60 0–40 0–4 1–40
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Note. M and SD are used to represent Mean and Standard Deviation, respectively

**

p<0.01

*

p<0.05.

3.2. Main Analysis

Two linear regression analyses examined the main (Model 1) and interactive (Model 2) effects of discrimination, alcohol use severity, and PTSD symptoms while controlling for age, sex, household income, and acculturation. In the Model 1 (see Table 2), the overall linear regression model for was significant, F(6, 178) = 9.02, p < .001, R2 = .23. The study found a significant main effect of discrimination on alcohol use severity (b = 0.17, SE = 0.08, β = .15; p = .044, 95%CI [0.01, 0.34]). Age was also significantly related to alcohol severity (b = 0.20, SE = 0.05, β = .27; p < .001, 95%CI [0.10, 0.30]), but PTSD symptoms and all other variables were not significantly related.

Table 2.

Factors Associated with Alcohol Use Severity

Model 1 β b SE t p 95% CI
 Constant - 11.711 3.726 3.143 .002 [4.357, 19.064]
 Age .274 0.198 0.053 3.779 <.001 [0.095, 0.302]
 Sex (male)* .027 0.501 1.242 0.403 .687 [−1.950, 2.951]
 Household income −.142 −0.692 0.359 −1.927 .056 [−1.400, 0.017]
 Acculturation −.132 −0.117 0.060 −1.958 .052 [−0.236, 0.001]
 Discrimination .145 0.171 0.084 2.031 .044 [0.005, 0.337]
 PTSD symptoms .116 0.644 0.396 1.626 .106 [−0.138, 1.425]
Model 2
 Constant - 13.994 3.627 3.858 <.001 [6.835, 21.152]
 Age .276 0.203 0.052 3.907 <.001 [0.101, 0.306]
 Sex (male)* .008 0.140 1.241 0.113 .910 [−2.310, 2.590]
 Household income −.136 −0.688 0.355 −1.935 .055 [−1.389, 0.014]
 Acculturation −.134 −0.114 0.059 −1.909 .058 [−0.231, 0.004]
 Discrimination .098 0.109 0.088 1.234 .219 [−0.065, 0.283]
 PTSD symptoms .109 0.601 0.393 1.532 .127 [−0.173, 1.376]
 Discrimination X PTSD symptoms interaction .151 0.103 0.048 2.120 .035 [0.007, 0.198]
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Note. Bolded typeface indicates significance at the p < .05 level.

*

Female reference group.

In model 2 (see Table 3), the overall model was significant, F(7, 177) = 8.52, p < .001, R2 = .25. The study no longer found significant main effects of discrimination on alcohol severity and PTSD symptoms remained nonsignificant; however, the interaction of discrimination by PTSD symptoms was significant (b = 0.10, SE = 0.05, β = .15; p = .035, 95%CI [0.01, 0.20]). As illustrated in Figure 1, analysis of simple slopes revealed that discrimination was significantly positively related to alcohol severity for those reporting high (1 SD above the mean; b = 0.28, SE = 0.10, p = .005, 95%CI [0.09, 0.47]) but not low levels of PTSD symptoms (1 SD below the mean). Age was also significantly related to alcohol severity (b = 0.20, SE = 0.05, β = .28; p < .001, 95%CI [0.10, 0.31]), but all other variables were nonsignificant.

Figure 1.

Figure 1

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Simple Slope Analyses of the Association Between Discrimination and Alcohol Use Severity at High and Low Levels of PTSD Symptoms (Model 2)

4. Discussion

4.1. Overview

Our study contributes to the literature by enhancing understanding of the association between discrimination, PTSD symptoms and alcohol severity among Latinx adults in the Northeast who engaged in heavy drinking, by investigating whether the association between discrimination and alcohol use severity differs by level of PTSD symptoms. The significant interaction indicated that experiences of discrimination were associated with alcohol severity among individuals who endorsed more PTSD symptoms, after controlling for sex, acculturation level, age, and household income. Consistent with previous findings among Latinx adults, discrimination experience was linked to alcohol use severity (Glass et al., 2020b; Otiniano Verissimo et al., 2014a) among Latinx adults who met criteria for heavy drinking. Adding to this, we found that discrimination’s association with alcohol use severity varied by PTSD levels. Our findings suggest that there may be an additive negative effect of more PTSD symptoms on drinking for Latinx adults who have experienced discrimination.

4.2. PTSD symptoms among Latinx adults in the Northeast

Nearly 40% of our sample scored at or above 3 on the PC-PTSD, indicating probable PTSD (Prins et al., 2003). This is comparable to rates of PTSD symptoms found among substance use treatment-seeking populations (25%−50%) (Jacobsen et al., 2001; Naifeh et al., 2012; Prins et al., 2003). Our study participants were older (e.g., mean age 41 years) and not from the same country of origin as those in earlier studies examining PTSD and alcohol misuse. Nearly 60% were from the Caribbean (Puerto Rico or the Dominican Republic), about one third were from South or Central American, and a few study participants were from Mexico, in contrast to studies that have mainly been conducted with Mexican Americans in the Southwest.

Anti-immigrant climate may have traumatic effects on Latinx individuals nationwide, far from the Mexican border. The Diagnostic and Statistical Manual of Mental Disorders (Diagnostic and Statistical Manual of Mental Disorders, 2013) defines trauma as having exposure to actual or threatened death, serious injury, or sexual violence. Immigration policies and their harsh enforcement (e.g., immigration raids, detention and deportation, arrest, and family separation), have been associated with the development of post-traumatic symptoms such as avoidance (e.g., not going outside because of fear of arrest (Chavez-Dueñas et al., 2019)). Acts of discrimination are traumatic if they are hostile, threatening, sudden, and the victim has no control over the event (Flores et al., 2010a). The Ethno-Racial theory of trauma posits that experiences of discrimination, violence and intimidation involve physical and psychological threats to individual well-being, so are consistent with definitions of DSM-5 definitions of trauma (Comas-Díaz et al., 2019). A contribution of the study is to demonstrate that, despite demographic differences in the Latinx sub-National composition in the Northeast versus the Southwest, that anti-immigrant enforcement happens everywhere in the U.S. (Chavez-Dueñas et al., 2019; Morey et al., 2018; Pinedo, 2020).

4.3. Discrimination and PTSD symptoms

Our findings suggest that exposures to discrimination and anti-immigrant prejudice may contribute to PTSD symptoms, so must be considered when working with Latinx individuals. Over 90% of our study participants experienced discrimination, and greater discrimination was associated with worse alcohol use severity even after controlling for acculturation level. This study finding suggests that Latinx adults in our study, regardless of level of acculturation, experienced discrimination (Otiniano Verissimo et al., 2014a; Yip et al., 2008). Similarly, household income did not influence the relationship between discrimination and alcohol use severity, suggesting that regardless of income level, discrimination exerts harmful effects. These findings are consistent with prior research showing positive associations between higher income or acculturation level, experiences of discrimination and adverse health outcomes (Viruell-Fuentes, 2007; Perez-Rodriguez et al., 2014.

Our sample showed evidence of accumulated social disadvantages, which can translate into lower thresholds for experiencing the psychological impact associated with traumatic exposures (Alcántara et al., 2013; Frohlich & Potvin, 2008). Put another way, for such individuals, exposure to traumatic events may be more likely to develop into PTSD symptoms if the individual has fewer psychological and social resources to cope with the traumatic exposure. Furthermore, stressors related to acculturation, which include discrimination, have been shown to increase the risk for PTSD which in turn could lead to increased substance use. Flores et al. hypothesized that the effects of traumatic exposures degrade mental health by spurring hypervigilance to further incidents, increasing anxiety and depression, and lowering self-esteem, which may predispose individuals towards risky behaviors like heavy drinking as a way of coping with psychological distress (Chavez-Dueñas et al., 2019; Cheng & Mallinckrodt, 2015; Ehlers et al., 2016; Flores et al., 2010b).

The remaining covariates were age, sex, and income. The study also found older age to be related to alcohol use severity. Although it is beyond the scope of this study to inquire further, we speculate that age may be a proxy for other factors such as prolonged exposures to social disadvantage, discrimination, or marginalization that might increase vulnerability to substance use. It might also be that it represents a length of time during which an individual misused alcohol and did not receive early intervention. Future research should investigate the pathways through which age increases risk for alcohol misuse. The study did not find sex to be related to alcohol use severity. This suggests that the relationship between discrimination and alcohol use severity is pronounced among those with more PTSD symptoms for all Latinx adults.

4.4. Study limitations

Although evidence suggests that experiences of discrimination can have traumatic impacts, in this cross-sectional analysis we are unable to determine whether discrimination preceded PTSD symptoms or heavy drinking. Relatedly, it is not known what event or events drove the high PTSD prevalence here. The PTSD symptoms may have been unrelated to an experience of discrimination, even though experiences of discrimination were nearly universally reported by study participants. Second, we enrolled Latinx individuals who met the criteria for heavy drinking days, so findings may not be generalizable to the Latinx population who do not screen positive for heavy drinking days. Third, the PC-PTSD is not diagnostic of PTSD (Prins et al., 2003).

5. Conclusion

Evidence suggests that among Latinx adults who have experienced discrimination, PTSD heightens risk for alcohol use severity. As a first step, screening Latinx adults who are positive for heavy drinking days, for discrimination and PTSD is clinically important. Relatedly, developing and offering culturally-adapted alcohol interventions that address experiences of discrimination and PTSD may be needed and the timing of intervention delivery may be important (Sanchez et al., 2014). Such interventions might mitigate the risk of increased alcohol use among Latinx adults by identifying and addressing exposures to traumatic experiences among Latinx individuals that can occur before, during (the migratory process) and after U.S. arrival (i.e., post-immigration) (de Arellano et al., 2018; Sanchez et al., 2014). In either case it would be important to isolate the cause and nature of the traumatic event experienced at the time of exposure (e.g., during migration or after U.S. arrival) and develop the intervention to target the frequency and types of traumatic exposures experienced. For example, robberies and sexual assault have been identified as sources of “in-transit trauma” among Latinx immigrants (de Arellano et al., 2018). When participants arrive in the U.S., they are more likely to be exposed to discrimination and stigma as a result of anti-immigrant policy and rhetoric.

5.1. Future directions

Qualitative studies examining how experiences of discrimination have traumatic impact can be used to help inform the consideration of DSM-5 diagnostic criteria for PTSD (Pittman, 2014) for Latinx individuals. Assessments of PTSD should be tailored to include traumatic events, such as robberies, accidental injury, and sexual assault, that occur in the course of migration to the U.S. (de Arellano et al., 2018). Studies should also broaden into the effects of stressors related to the acculturation process and immigration that have been associated with increased alcohol use among Latinx immigrants (De La Rosa et al., 2012; Sanchez et al., 2014). Research using a mediational approach can examine the relationship between discrimination, the development of PTSD symptoms, and alcohol use severity, among Latinx adults. To this end, using measures like the Trauma Symptoms of Discrimination scale (M. T. Williams et al., 2018) could be used to investigate the impact of discrimination as a traumatic experience on alcohol outcomes among Latinx adults. Such studies will help to shed light on whether people of color use substances to cope with the effects of trauma that can be occasioned by exposures to acts of anti-immigrant discrimination.

Highlights.

  • 40% of Latinx adults positive for heavy drinking days had elevated PTSD symptoms

  • PTSD may have additive effects to discrimination that worsen drinking

  • Screening Latinxs who drink alcohol for discrimination, PTSD is clinically important

  • Alcohol interventions targeting discrimination may be helpful for worse PTSD

Role of funding source:

This research was supported by a grant from the National Institutes of Health/National Institute on Alcoholism and Alcohol Abuse AA021136. The NIAAA had no role in the study design, collection analysis, interpretation of data, or in writing of the report. Work on this manuscript by the second author (TN) was supported by National Institute on Drug Abuse grant F31DA053754 and by National Institute on Alcohol Abuse and Alcoholism grant R25AA028464.

Footnotes

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Conflict of interest: There are no conflicts of interest to disclose.

1

We are using the term Latinx to be gender inclusive but recognize that the term preferred by most individuals from Latin American countries are the nationality of origin or the terms Hispanic, Latinx (for male identified) or Latina (female identified) (Noe-Bustamante et al., 2021).

2

In the completed clinical trial, the trial sample size (n=250) was based on an estimated effect size of d =.25 and power of .80. The achieved sample size (n=296) was 18% larger than originally proposed (Lee et al., 2019).

Contributor Information

Christina S. Lee, Boston University School of Social Work. 264 Bay State Road, Room 354, Boston, MA 02215

Tessa Nalven, Dept. of Psychology, University of Rhode Island

Audrey Hai, Tulane University School of Social Work.

Miguel Pinedo, Dept of Health Sciences, University of Texas at Austin.

Victoria Lopez, Boston University

Melanie Morris, Boston University School of Social Work.

Jorge Delva, Boston University School of Social Work.

Miguel Cano, Dept. of Epidemiology, University of Texas Southwestern

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