Document Type


Date of Award


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Raluca M Simons


Alcohol use poses a significant public health concern, particularly among young adults, 35% of whom report binge drinking (SAMHSA, 2019). Childhood maltreatment is reported by over 50% of young adults (Maples et al., 2014) which places individuals at a greater risk of problematic drinking (Goldstein et al., 2010). Developmental traumatology theory posits that 1) maltreatment-related psychobiological changes are responsible for the increased risk of dysfunctional alcohol use in maltreated individuals and 2) PTSD may be a good indicator of this psychobiological change (De Bellis, 2002). PTSD symptoms have mediated the relationship between childhood maltreatment and alcohol outcomes in previous studies (Epstein et al., 1998; Rosenkranz et al., 2014). However, these studies have significant sample limitations that preclude generalizability. Furthermore, this explanation does not include established learning theories traditionally used to explain the connection between PTSD and problematic alcohol use. Reinforcement sensitivity theory (RST) posits that subsystems of the brain responsible for approach and avoidance behavior can have idiosyncratic tendencies of activation reflected in our sensitivity to the rewarding (SR) and punishing (SP) qualities of stimuli, respectively (Corr, 2016; Gray 1991). While RST has been used to explain alcohol use, few studies have researched RST in connection with childhood maltreatment and PTSD. The current study tests a structural equation model to determine if childhood maltreatment and PTSD symptoms influence alcohol outcomes via changes in SR and SP. It was hypothesized that the associations between childhood maltreatment and alcohol outcomes will be explained, at least in part, by PTSD symptoms and SR/SP. Gender was controlled for. Results generally confirm this hypothesis with some exceptions. SR, but not SP, significantly predicted alcohol use, though both significantly predicted alcohol-related problems. Additionally, adding a path from childhood maltreatment to alcohol-related problems improved model fit. These findings suggest that the relationship between childhood maltreatment and alcohol-related problems is only partially explained by the development of PTSD symptoms and their influence on reinforcement sensitivity and alcohol use. These results point to the usefulness of interventions that target PTSD symptoms and reinforcement sensitivity in maltreated individuals in order to reduce the likelihood of experiencing problematic alcohol use.

Subject Categories

Clinical Psychology


Alcohol use, Childhood maltreatment, PTSD, Reinforcement sensitivity

Number of Pages



University of South Dakota



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.