Post-Traumatic Stress Disorder and Impulsive and Risky Behavior: Overview and Discussion of Potential Mechanisms

Abstract

Post-traumatic stress disorder (PTSD) is associated with a high level of functional impairment, comorbid psychiatric disorders, suicide, and various physical health problems. A growing body of research also shows that individuals with PTSD are at elevated risk for engaging in a number of impulsive and risky behaviors, including substance abuse, risky sexual behavior, non-suicidal self-injury, and eating disordered behavior. The presence of these behaviors among individuals with PTSD may lead to more extensive and worse functional impairment, as well as complicate the treatment of PTSD. Consequently, additional research is needed that focuses on understanding why individuals with PTSD may be at high risk for developing these behaviors, as well as the best methods for preventing and reducing these behaviors. With this goal in mind, this chapter reviews this literature and offers a discussion of mechanisms that may underlie the relationship between PTSD and impulsive and risky behaviors. Specifically, given evidence that difficulties in emotion regulation and impulsivity are elevated among individuals with PTSD and associated with greater risk-taking behaviors, these two constructs are proposed as potential mechanisms that may account for the PTSD-impulsive and risky behavior connection. Finally, given the clinical relevance of impulsive and risky behaviors among individuals with PTSD, treatment recommendations are offered for reducing these behaviors when working with patients with PTSD.