Author ORCID Identifier

Document Type


Date of Award


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Raluca M Simons


Posttraumatic Stress Disorder (PTSD) is a common concern for veterans involved in the post-9/11 Iraq and Afghanistan conflicts (Epidemiology, 2017). Alcohol use is highly comorbid with PTSD in returning veterans (Seal et al., 2011). There are several models for the complex relationship between these two constructs including self-medication models or as an attempt to regulate emotion. Sleep disturbances have been linked to PTSD and alcohol use (Conroy & Arnedt, 2014) and could be driving the relationship. It is also possible that difficulties in emotion regulation could be part of this relationship either independently (Kelly & Bardo, 2016; Perlick et al., 2017) or in conjunction with sleep disturbances (Fairholme et al., 2013). This study used 14 days of experience sampling data collected from 59 veterans about PTSD symptoms, alcohol use, sleep disturbance, and emotion regulation. Participants answered several questions throughout the day using an application on their phone. They received an actigraph to approximate their sleep parameters including sleep efficiency and total sleep time. Multi-level modeling was used to explore the temporal relationships at the between- and within-subjects level of PTSD symptoms, alcohol use and problems, sleep disturbance and emotion regulation. Multimethod data collection using self-report, objective approximation of sleep measures (actigraphy), and experience sampling in the same study is innovative. Results of the study suggested that sleep disturbances did not have significant associations with PTSD symptoms, emotion regulation, or alcohol consumption in multilevel models, there were some significant correlations. Exploratory analyses using other objective sleep approximations and a subjective sleep variable mimicked these results. Future studies would benefit from a more diverse sample and a variety of assessment methods for subjective and objective experiences of sleep.

Subject Categories



Alcohol, Emotion Dysregulation, PTSD Symptoms, Sleep, Veterans

Number of Pages



University of South Dakota

Included in

Psychology Commons



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