Assessing the Correlation Between Alcohol Abuse, Depression, Anxiety Disorder, and Posttraumatic

Stress Disorder on College Students in the United States: A Literature Review

Department of Health Promotion and Behavior, University of Georgia

HPRB5410W: Professional Writing for Health Promotion

Caitlyn Dougherty

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Assessing the Correlation Between Alcohol Abuse, Depression, Anxiety Disorder, and Posttraumatic

Stress Disorder on College Students in the United States: A Literature Review

Research Question:

How are mental disorders, such as anxiety disorder, depression, and posttraumatic stress

disorder, related to alcohol abuse in college students in the United States?

Abstract:

College students in the United States suffer from many stressors as well as mental

illnesses such as posttraumatic stress disorder (PTSD), anxiety disorder, and depression. When

these disorders are combined with alcohol abuse there can be many negative consequences. The

purpose of this literature review is to analyze the association between alcohol abuse, depression,

anxiety disorder, and PTSD in college students in the United States. This literature review used

information from twelve articles to analyze the relationship between these mental disorders and

alcohol abuse from PsycINFO and PubMed databases. These studies were observational and

located within the United States. This literature review found that there is no causation between

these mental disorders and alcohol abuse; however, when people with these mental disorders

abuse alcohol for an extended period there may be adverse consequences. Also, there is an

increased risk of alcohol abuse within men, as well as an increase in alcohol abuse related to

social anxiety and the effects of solitary drinking. Future analyses should focus on longitudinal

studies to analyze lifelong effects of having an alcohol abuse disorder coupled with a mental

disorder. These studies should also focus on treatment, and which kinds of treatment are most

successful in college students.

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Table of Contents

Research Question:.................................................................................................................2
Abstract:.................................................................................................................................2
Introduction............................................................................................................................4
Methods.................................................................................................................................6
Figure 1: Article Process Selection for Literature Review.......................................................8

Results....................................................................................................................................9
Effects of Mental Illness on Alcohol Abuse .............................................................................9

Biological Sex and its relation to alcohol use disorder and mental illness............................10

The Association between Social Anxiety and Solitary Drinking............................................11

Table 1 Articles in Review........................................................................................................13

Discussion.............................................................................................................................17
Limitations................................................................................................................................19

Implications..............................................................................................................................20

Conclusions...............................................................................................................................20

References............................................................................................................................22

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 Introduction

College is an exciting time in a person’s life. People can make friends and choose the

path they wish to continue. However, despite that excitement of college, there are many

challenges and temptations. College students are typically burdened with academic, social, and

financial stresses which can put a strain on their mental health. These stresses can impact the

mental stability of a college student which in turn can impact their actions and decision making.

Because of these mental stresses and temptations, students may turn to alcohol as a coping

mechanism. Due to this, the issue of alcohol abuse on college students is significant, especially

when considering mental illnesses such as anxiety disorder, depression, and posttraumatic stress

disorder (PTSD). It has recently been reported that 17% of college students are suffering from

depression and 14% are suffering from anxiety; and these statistics are only growing (Hoying et

al., 2020). These mental illnesses not only put a strain on the life of a college student, but they

can physically endanger them. For example, college students are more likely to over consume

alcohol or binge drink when they have some form of anxiety (Krieger et al., 2018).

Binge drinking is a form of alcohol abuse that can be described as having five or more

drinks on a single occasion. It has been shown that nearly 40% of college students have taken

part in activities involving drinking that have led to overconsumption or binge drinking

(Woolman et al., 2015). This is a very prevalent issue and in current studies it has been reported

two thirds of college students drink alcohol, and about half of these students are also binge

drinking on a regular basis (Nourse et al., 2017). By engaging in binge drinking, it has been

shown short-term consequences such as academic impairment, hazardous health behaviors, and

decrease in self-care are likely to occur (Woolman et al., 2015). Also by engaging in these

4
behaviors, it can increase the possibility of long-term effects such as alcohol abuse disorder and

addiction, and this is even more prevalent when students use alcohol to cope with their mental

illnesses (Woolman et al., 2015).

Based on this information it is apparent that the level of alcohol consumption on college

campuses has become significant, and with increased research mental health has become more

widespread and discussed. However, on college campuses it has been shown that only about

38% of the college population struggling with depression or anxiety actually seek treatment

(Nourse et al., 2017). This information can be alarming especially considering that anxiety and

alcohol use disorders occur together nearly 50% of the time (Villarosa-Hurlocker & Madson,

2020). The typical treatment for mental illnesses includes practitioner prescribed medications

combined with therapy; however, of the individuals tested positive for an anxiety disorder only

52% received the care that they needed (Capron et al., 2018). When considering care for alcohol

abuse disorder, colleges typically provide services; however, it has been shown that protective

behavioral strategies have been more successful to target the harms of problem drinking. These

strategies are ways to teach individuals how to be safe while drinking instead of telling the

students not to engage in these activities (Jordan et al., 2019).

When addressing the issue of substance use disorder there are several obstacles. When

speaking about this issue it is common for it to appear as victim blaming because there is a

stigma around excess drinking, especially since this population consists of primarily

undergraduate students who may be underage. However, this topic is increasingly important

because if alcohol abuse is addressed early, it can lessen short-term and long-term effects such as

decreased academic and social performance as well as decreasing the likelihood of the disorder

progressing throughout life (Capron et al., 2018). Furthermore, the long-term effect of alcohol

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abuse on the brain and body is significant. For example, the amygdala and prefrontal cortex can

be altered by binge drinking and people who frequently binge drink typically have irregular EEG

patterns (Krieger et al., 2018).

Though much is known about alcohol use and mental health individually there is a gap in

the knowledge about how mental illness and alcohol abuse are interrelated in college students

(?). This means that there is typically skepticism about whether drinking leads to psychological

disorders, or if psychological disorders lead to drinking. This issue is particularly important to

public health because anxiety and depression have increased from year to year; therefore, it is

important to study mental illness and alcohol abuse together to better health outcomes for college

students (Nourse et al., 2017). This literature review aims to explore the relationship between

mental illness such as anxiety, depression, and PTSD and its association with alcohol abuse in

college students in the United States.

Methods

When conducting this literature review the databases chosen were PubMed and

PsycINFO. PubMed was chosen because it would allow for medical studies to be included in

this literature review. The database PsycINFO was chosen because since this literature review is

focused on the mental disorders such as posttraumatic stress disorder, anxiety disorder, and

depression it is important to have informative and reliable studies regarding these topics.

For the database PubMed, the final search terms included “alcohol abuse disorder” AND

“anxiety disorder” AND “college students”. When including the time restriction of years 2012

to 2022 with full text options there were 27 available articles. Studies outside of the United

States were excluded to narrow the search. Based on the inclusion and exclusion criteria and

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examining articles that pertained to this research question, these articles were narrowed down to

five that are included within this literature review.

For the database PsycINFO, the same search terms, “alcohol abuse disorder” AND

“anxiety disorder” AND “college students” were used finding 177 results. Using an advanced

search, the time frame was selected to be between 2012 and 2022, only peer reviewed articles

were selected, and the studies were limited to only observational studies. This allowed 17

results. These results were then limited to within the United States and only pertaining to

alcohol which limited these articles to seven.

After these searches, the articles were narrowed by inclusion and exclusion criteria.

Articles were only included if they were peer reviewed and the full text was available. When

using the database, PubMed, the articles are already peer reviewed, so no filter was needed for

this database. The time frame was set to only include articles between the years 2012 and 2022

so that the most recent articles would be available. Also, disorders were limited to posttraumatic

stress disorder, depression, and anxiety disorder. Also, articles were limited to studies done in

the United States. Study design was limited to observational studies for ethical purposes as well

making sure the population was contained to humans and not experiments on non-human

subjects. These types of studies include longitudinal studies, cross-sectional studies, surveys,

prospective observation studies, and a latent profile analysis. Also, systematic and literature

reviews were excluded from being used in this literature review. Lastly, articles were excluded

that contained information pertaining to other substances such as opioids or marijuana to ensure

that the findings were not too broad or confounding due to aspects other than alcohol abuse.

Based on these keywords and criteria 12 articles were chosen, seven from PsychINFO and five

from PubMed. The process for selecting these articles is described further in Figure 1.

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Figure 1: Article Process Selection for Literature Review

Studies Studies
selected from selected from
PubMed PsycINFO

Search 1: "alcohol abuse

Search 1: "anxiety disorder"
disorder"
publication dates: 2012-2022
publication dates: 2012-2022
n= 71,947
n= 23,192

Search 2: "alcohol abuse Search 2: "anxiety disorder

disorder AND anxiety disorder" AND alcohol abuse disorder"
n= 2,012 n= 3,040

Search 3:"alcohol abuse disorder Search 3: "anxiety disorder

AND anxiety disorder AND AND alcohol abuse disorder
college students" AND college students"
n= 50 n= 177

Search 4:"alcohol abuse disorder

AND anxiety disorder AND Inclusion/ exclusion
college students" Limit to: peer reviewed,
limiation: within the united observational studies
states n=17
n=27

Inclusion/ Exclusion
Inclusion/ Exclusion
Limit to: within the United
Limit to: articles referencing States, alcohol only
substances other than alcohol
n=10

Total number of articles chosen Total number of articles chosen

based on research criteria based on research criteria
n=5 n=7

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 Final number of articles chosen: 12

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 Results

For the purpose of this literature review twelve articles were chosen to assess the

association between certain mental disorders and alcohol abuse. These articles included college

students in the United States who suffered from mental illness and alcohol abuse. All the articles

included were observational studies with the majority being cross-sectional studies or surveys.

Articles were eliminated if they contained information about other substances or if the studies

were conducted outside of the United States. Within these articles information was primarily

self-reported by the individuals, which allowed for an association to be shown between alcohol

abuse and mental disorders but could not verify any causation. Also, within these articles, there

are some discrepancies that aid in causation not being able to be drawn. Reference Table 1 for

more detail about the articles selected. These articles analyze the impact of social and solitary

drinking on mental illness and alcohol abuse, differences of alcohol use between sexes, and how

alcohol abuse is specifically related to mental illnesses.

Effects of Mental Illness on Alcohol Abuse

A common aspect outlined in most of these articles was if there was causation between

alcohol abuse disorder and other mental disorders? A study in Pennsylvania gave a survey was to

201 undergraduate students, and it was found that 29.4% of students felt depressed before they

began to drink, whereas only 15.9% of these students said that drinking lessened their

depression. From the same study it expresses that, 36.3% of students suffered from anxiety

problems before they began to drink, where only 18.9% said that drinking lessened their anxiety

(Nourse et al., 2017). However, despite these statistics, a definite relationship cannot be found

between these disorders and alcohol abuse because many students come to college with these

10
disorders, and it cannot be determined how these disorders were affected by their alcohol use

(Woolman et al., 2015).

Further, binge drinking was also not linked to anxiety or depression, but was linked more

to social norms such as, what a person’s friend group is doing or what college students think they

are supposed to be doing (Nourse et al., 2017). Aligning with these findings, a alcohol

intervention trial was conducted in 138 undergraduate students and found that depressive

symptoms were more associated with the aspect of self-care, and there symptoms were not

possible to predict the drinking behaviors of these individuals (Acuff et al., 2018).

Analyzing the relationship between PTSD and alcohol abuse, it follows the same trend as

depression and anxiety. No matter the severity of PTSD the relationship between people with

this disorder, academic stress, and drinking to cope could not be proven because of lack of

evidence (Woolman et al., 2015). However, in an longitudinal study of 336 undergraduate

psychology students, it found evidence that with differing symptoms occurring with PTSD,

there may be an increased risk for alcohol misuse as well as negative consequences (Himmerich

et al., 2020). Also, in an assessment of 296 undergraduate students in a survey study, it was

found that the more trauma that a person is exposed to, the more risk they are at for problem

drinking, and if they were exposed to these traumas at an early age, they will likely start drinking

earlier in life (Berenz et al., 2019).

Biological Sex and its relation to alcohol use disorder and mental illness

Though drinking among college students is common there is a difference in drinking

patterns between different sexes, and a difference in how mental illnesses may be affecting them.

When looking at the consistency of drinking, men tend to drink more than women considering

occurrences for the week, month, and year. Not only were they drinking more, 21.6% of males

11
claimed that they had memory loss while drinking while only 11.3% of women reported this

(Nourse et al., 2017). Furthermore, in a profile analysis of 674 students, it was discovered that

men were more likely to drink in riskier manners than women and were more likely than women

to consume alcohol to deal with social anxieties (Villarosa-Hurlocker & Madson, 2020).

Not only is basic alcohol consumption different between sexes, but so are mental

disorders and how they moderate alcohol consumption. A primary difference between women

and men is that for women only, the younger they were when they first began drinking alcohol

contributed to PTSD, anxiety, and depression even when conditions were relatively the same for

both sexes (Berenz et al., 2019). Furthermore, when looking at PTSD there are also fewer

negative consequences for men compared to women. An online survey given to 7,307 students

across the United States, revealed that PTSD coupled with alcohol abuse created more negative

consequences among women. For this reason, it was more likely for women to change their

drinking habits than it was for men (Jordan et al., 2019).

Lastly, the behaviors and situations in which sexes drink differs as well. In a longitudinal

study composed of 754 college students, found that 44% of men are shown to drink in solitary

compared to 30% of women who drank in solitary. However, it was reported that women were

less likely to report solitary drinking than men likely because of embarrassment or because they

do not believe it is something women do (Fleming et al., 2021).

The Association between Social Anxiety and Solitary Drinking

The final continuity in this literature is the association between social anxiety and social

and solitary drinking habits. The severity of alcohol consumption is complicated by the concept

of social anxiety. For example, a cross-sectional study of 232 college students found that social

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anxiety disorder increases the likelihood of developing an alcohol abuse disorder by almost four

times; however, this does not mean that the person will drink more frequently but increases the

times in which a person with social anxiety will drink alone (Terlecki & Buckner, 2015). Also,

there is a positive correlation between social anxiety and solitary drinking but a negative

correlation with social drinking (Buckner & Terlecki, 2016).

Considering the correlation between social anxiety and solitary drinking, it is more likely

that when a person with social anxiety does drink alone, they are more inclined to alcohol

misuse. In a separate cross-sectional study by authors Buckner and Terlecki in 2016, it has been

shown that solitary drinking can lead to more alcohol related issues (Buckner & Terlecki, 2016).

It has also been shown that people who suffer with social anxiety are more likely to drink if they

have experienced negative emotions instead of trying to participate in social activities (Terlecki

& Buckner, 2015). However, not all social anxiety is represented in the same way; for example,

for many individuals their social anxiety stems from how others look at them while they are

drinking. For these reasons people with higher levels of social anxiety tend to abuse alcohol

more than those with lower levels of social anxiety (Villarosa-Hurlocker & Madson, 2020).

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 Table 1 Articles in Review

Author(s) Year Article Tile and Purpose of the Sample info Type of Research findings Limitations of
Journal article research article
1 Bravo, A.J. 2019 To evaluate the role 7307 college students Online survey This article found that This study relied on
Posttraumatic stress
Jordan, H.R. of alcohol and from the Psychology there was a positive convenience
disorder symptoms and
Madison, M.B. gender when Department of correlation between samples which
problematic alcohol use
Nicholson, B.C. looking at PTSD Participant Pools. PTSD symptoms and makes it difficult to
in college students: The
Pearson, M.R. and alcohol induced alcohol related generalize.
moderating role of
consequences. consequences.
alcohol protective
behavioral strategies
and gender
Journal Psychological
Trauma: Theory,
Research, Practice, and
Policy

2 Cadigan, J.M. 2021 To find the 754 college aged Longitudinal Based on this article it Within this study
Antecedents,
Fleming, C.B. association between individuals. 59% study shows that depressive there was the age
concurrent correlates,
Jaffe, A.E. solitary alcohol use white, 18% Asian, symptoms can lead to and educational
and potential
Lee, C.M and coping motives 5% black, and 18% more solitary drinking status was different
consequences of young
Mason, W.A. when paired with other. which in turn can lead in individuals
adult
Rhew, I.C. mental disorders to more depression. regarding life
solitary alcohol use.
Stevens, A.L. such as depression. circumstances.

Psychology of
Addictive Behaviors
3 Adamsjick, P 2017 College binge drinking This article was 201 college students Prospective This article showed that The sample size was
Nourse, R. and its association with conducted to find observational there are many relatively small and
Stoltzfus, J. depression and anxiety: data relating binge study consequences when contained mostly
A prospective drinking and its looking at binge females.
observational study. association with drinking and mental
anxiety and disorders such as
Hong Kong Journal of depression. depression and anxiety.

14
 Psychiatry

Table 1 Articles in Review Continued

Author(s) Year Article Tile and Purpose of the Sample info Type of Research findings Limitations of
Journal article research article
Madson, M.B. 2019 A latent profile To identify college 674 college Latent profile Social anxiety can Students had to
4
Villarosa-Hurlocker, analysis of social students and the students, 69.6% analysis by a cause adverse drinking display their
M.C. anxiety and alcohol relationship between female survey. behavior and these two previous two month
use among college social anxiety and aspects are interrelated. drinking history
students. alcohol abuse. which may have led
to some exclusion
Journal of Addict because of the social
Behaviors anxiety aspect.
Buckner, J.D. 2016 Social Anxiety and This study is 776 students Cross- Based on this study This study included
5
Terlecki, M.A. Alcohol-Related intended to look including a 83.5% sectional social anxiety led to a homogenous
Impairment: The further into ways female population. study more solitary drinking young adult
Meditational Impact of that social anxiety but was negatively population, so it is
Solitary Drinking can lead to increased associated with social difficult to broadly
drinking. drinking. generalize these
Journal of Addict results.
Behaviors
Buckner, J.D. 2015 Social Anxiety and To evaluate the 232 undergraduate Cross- When students have Because this is a
6
Terlecki, M.A. heavy situational motives for college students sectional high social anxiety, cross-sectional study
drinking: coping and students to drink study they are more likely to it is difficult to draw
conformity motives as based on social heavily drink in causal relationships.
multiple mediators anxiety. situational settings.

Journal of Addict
Behaviors

15
 Table 1 Articles in Review Continued

Author(s) Year Article Tile and Journal Purpose of the Sample info Type of Research findings Limitations of
article research article
7 Amstadter, A.B. 2018 Age of alcohol use This study aims at 269 undergraduate Longitudinal This article found This study used
Berenz, E.C. initiation and psychiatric evaluating the age students including study that the earlier self-reported
Dick, D. symptoms among young of alcohol 74.7% women. initiation of alcohol measures which
McNett, S. adult trauma survivors initiation as well is related to could influence the
Rappaport, L.M. as sex and how it increased results.
Viana, A.G. Journal of Addict related to PTSD, psychiatric
Vujanovic, A.A. Behaviors anxiety, and symptoms
depression. especially in
women.
8 Acuff, S. F. 2018 Depressive Symptoms as The main purpose 138 university Cross- This article found This study uses
Dennhardt, A. A. predictors of alcohol of this article is to students in their first sectional that people who information that
Luciano, M. T. problem domains and look at symptoms and second year who study use alcohol as self- was self-reported
Meshesha, L. Z. reinforcement among of depression and were in intervention medication may meaning the
Murphy, J. G. heavy drinking college how they may be trials. worsen the participants may
Pedrelli, P. students a predictor of depression not have answered
Soltis, K. E. alcohol abuse in symptoms. completely
college students honestly.
who heavily
drink.
9 Becker, M. M. 2015 The purpose of 200 undergraduate Cross- This article found This study was
PTSD Symptoms Mediate
Klanecky, A. K. this article was to studies with varying sectional that people who only conducted on
Academic Stress and
Woolman, E. O. find the ethnicities. survey experienced early college students
Drinking to Cope in
correlation trauma are more and may not be
College Students
between likely to have generalized to a
Journal of Drug posttraumatic increased academic non-college student
Education stress disorder, stress which may population.
academic stress, increase drinking
and alcohol use. behavior

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 Table 1 Articles in Review Continued

Author(s) Year Article Tile and Journal Purpose of the Sample info Type of Research Limitations of
article research findings article
10 Ellis, R. A. 2020 Application of PTSD The purpose of 336 undergraduate Survey There was a The levels of
Himmerich, S. J. alcohol expectancy this article was to students relationship posttraumatic
Orcutt, H. K. symptom clusters to the discover a between stress were
four-dimensional model relationship posttraumatic relatively low in
of PTSD: Support from between stress and alcohol this population.
moderations of the posttraumatic consumption.
association between stress disorder and
symptoms of alcohol
posttraumatic stress and consumption.
alcohol use.

Psychological Trauma:
Theory, Research,
Practice, and Policy

17
 Discussion

To be able to monitor and change alcohol abuse repercussions in college students it is

important to understand how mental disorders specifically affect how and when a person decides

to consume alcohol. By understanding and grasping this concept increased treatment and

preventative measures can be taken to decrease the amount of alcohol abuse among college

students. This literature review examined the relationship between alcohol abuse, anxiety

disorder, depression, and PTSD. Through analyzing the literature, several overarching themes

were relevant. These include the effect of mental illness on alcohol abuse, sex and its relation to

alcohol use disorder and mental illness, and the correlation between social anxiety and solitary

drinking.

The first finding considered the effect that mental illness had on alcohol abuse. Based on

the findings, though there tends to be a correlation between alcohol consumption and mental

disorders there is not a causative relationship. Though problem drinking can typically be

correlated with depression and anxiety, with the research that has been collected up to this point

we cannot say that there is a definite cause and effect relationship (Obasi et al., 2016). Though

there is no definite causation, there are certain factors of mental disorders that can worsen

drinking problems. For example, when a person engages in more self-blaming thoughts, or if

they use alcohol to cope with a negative feeling or outcome in their life, they may abuse alcohol

(Obasi et al., 2016). Furthermore, when looking at PTSD the risk for alcohol abuse is most

common when trying to reduce the symptoms that may be causing their PTSD, such as trying to

alter mood or numb hyperarousal (Himmerich et al., 2020).

The second finding considered sex and its relation to alcohol use disorder and mental

illnesses. Through the analysis of the literature, it is apparent that men drink more on average

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than women; however, the way in which they drink differs. As previously mentioned, when

looking at PTSD women are more likely to experience negative consequences. This agrees with

another article from PubMed expressing that if women binge drink they are more prone to

negative cognitive effects (Krieger et al., 2018). However, women are also more likely to

change their drinking habits based on these negative consequences than men. For example, if the

PTSD is alcohol related women typically feel the need to protect themselves more and not

engage in this activity than men (Jordan et al., 2019). This can be related to gender norms where

women are not supposed to put themselves in risky positions, where a man in the same position

might not feel a threat. For these reasons, women are also more likely to seek treatment or use

alcohol protective behavioral strategies than men (Jordan et al., 2019). Women have also been

shown to display over twice the number of depressive symptoms than men; however, when

correlating this to alcohol consumption there was not a significant measure to show that these

symptoms increased the chances of problem drinking (Fleming et al., 2021). However, because

of societal norms and the fact that these depressive symptoms were self-reported the symptoms

for men may be underrepresented.

The third finding analyzes the correlation between social anxiety and solitary drinking.

Based on the findings it is apparent that there is a correlation between increased social anxiety

and solitary drinking. Based on the literature there are several aspects that may determine how

much a person drinks in solitary. A person who is likely to engage in more solitary drinking will

likely do it because they are looking to avoid social situations especially if they know that these

situations will not have alcohol (Buckner & Terlecki, 2016). Also, people who are suffering

from social anxiety often feel that they do not have a support system, and when going through

distress they may not seek help for fear of embarrassment. These socially anxious people

19
typically drink to avoid negative emotions which can create a cycle of social anxiety and alcohol

abuse (Buckner & Terlecki, 2016). It is also important to consider that there are different ways

to cope with social anxiety some of these ways include avoiding social situations where alcohol

is not offered, or students may avoid drinking in social situations to avoid possible scrutiny

(Villarosa-Hurlocker & Madson, 2020).

Limitations

This literature review only analyzed evidence from 12 articles and there are many

resources that may have contradicting findings. Because this literature review covered a

complex topic, there is much more to find out, and the time frame for this literature review is not

long enough to compile and analyze all existing information relating to this topic. Another

limitation would be that there are many other mental illnesses; however, including these would

have made this literature review too broad. Within most of the articles chosen the information

was self-reported which can change the results of the studies, meaning that people could say they

experienced more mental disorders than are diagnosed, or they may not give an accurate

description of their drinking tendencies and histories. The articles chosen were also only from

the United States so these results cannot be generalized to college students throughout the world.

Furthermore, it is also important to note that these results were based on college students,

predominantly in their undergraduate years, meaning that these findings cannot be generalized to

non-college students, or different age groups within the United States. Lastly, two of the articles

chosen were written by the same authors. These articles did not cover the exact same content,

but they may have been biased and agreed with each other. Also, in several of the studies the

population consisted of predominantly females which may skew the findings.

20
Implications

For this topic, most of the studies conducted are based on self-completed surveys. In the

future for more conclusions to be drawn there needs to be an increase in longitudinal studies of

the participants to determine lifelong effects with these disorders. Based on this literature

review, it is important the practitioners begin to spend more time trying to diagnose and treat

mental health from a young age to avoid possible repercussions in the future. Aiding to the

claims of this review, it is expressed that students should be screened for mental illnesses upon

entering the university so treatment can be readily available (Hoying et al., 2020). Also, to begin

at a young age, instead of the typical teaching where students are told not to drink, there needs to

be more time spent teaching children from a young age the effects of excess drinking, and

protective behavioral strategies that will protect them if they do decide to drink. Also, this

review explains how women are most likely to look for treatment, and it is important to increase

access to these on college campuses as well as encouraging men to take advantage of them.

Because of the possible repercussions for alcohol misuse and mental illness, college students

need to become more informed of how and where they can be treated and make these

environments safe spaces.

Conclusions

A considerable amount of time and effort has gone into the research of alcohol abuse and

mental illness. These topics have progressively become well-known, and efforts are being made

to help these students understand earlier in their lives the repercussions of excess drinking.

Increasing the diagnoses of mental disorders and increasing treatment will lessen the long-term

effects of these disorders. Also, creating more programs such as the protective behavioral

strategies can influence the way in which college students go about consuming alcohol. Though

21
there are contradicting views on the causation of the relationship between mental illness and

alcohol abuse, it is apparent that there is a correlation and with more study the causation may

become apparent. This review helps to provide information concerning drinking tendencies

among college students and how they relate to mental disorders such as anxiety disorder,

depression, and PTSD.

22
 References

Acuff, S. F., Soltis, K. E., Luciano, M. T., Meshesha, L. Z., Pedrelli, P., Dennhardt, A. A., &

Murphy, J. G. (2018). Depressive symptoms as predictors of alcohol problem domains and

reinforcement among heavy drinking college students. Psychol Addict Behav, 32(7), 792-

799. https://doi.org/10.1037/adb0000397

Berenz, E. C., McNett, S., Rappaport, L. M., Vujanovic, A. A., Viana, A. G., Dick, D., &

Amstadter, A. B. (2019). Age of alcohol use initiation and psychiatric symptoms among

young adult trauma survivors. Addict Behav, 88, 150-156.

https://doi.org/10.1016/j.addbeh.2018.08.022

Buckner, J. D., & Terlecki, M. A. (2016). Social anxiety and alcohol-related impairment: The

mediational impact of solitary drinking. Addict Behav, 58, 7-11.

https://doi.org/10.1016/j.addbeh.2016.02.006

Capron, D. W., Bauer, B. W., Madson, M. B., & Schmidt, N. B. (2018). Treatment Seeking among

College Students with Comorbid Hazardous Drinking and Elevated Mood/Anxiety

Symptoms. Subst Use Misuse, 53(6), 1041-1050.

https://doi.org/10.1080/10826084.2017.1392982

Fleming, C. B., Mason, W. A., Stevens, A. L., Jaffe, A. E., Cadigan, J. M., Rhew, I. C., & Lee, C.

M. (2021). Antecedents, concurrent correlates, and potential consequences of young adult

solitary alcohol use. Psychol Addict Behav, 35(5), 553-564.

https://doi.org/10.1037/adb0000697

Himmerich, S. J., Ellis, R. A., & Orcutt, H. K. (2020). Application of PTSD alcohol expectancy

symptom clusters to the four-dimensional model of PTSD: Support from moderations of

23
 the association between symptoms of posttraumatic stress and alcohol use. Psychol

Trauma, 12(4), 347-355. https://doi.org/10.1037/tra0000480

Hoying, J., Melnyk, B. M., Hutson, E., & Tan, A. (2020). Prevalence and Correlates of

Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year

Graduate Health Sciences Students. Worldviews Evid Based Nurs, 17(1), 49-59.

https://doi.org/10.1111/wvn.12415

Jordan, H. R., Madson, M. B., Nicholson, B. C., Bravo, A. J., Pearson, M. R., & Protective

Strategies Study, T. (2019). Posttraumatic stress disorder symptoms and problematic

alcohol use in college students: The moderating role of alcohol protective behavioral

strategies and gender. Psychol Trauma, 11(3), 247-255. https://doi.org/10.1037/tra0000417

Krieger, H., Young, C. M., Anthenien, A. M., & Neighbors, C. (2018). The Epidemiology of

Binge Drinking Among College-Age Individuals in the United States. Alcohol Res, 39(1),

23-30.

Nourse, R., Adamshick, P., & Stoltzfus, J. (2017). College Binge Drinking and Its Association

with Depression and Anxiety: A Prospective Observational Study. East Asian Arch

Psychiatry, 27(1), 18-25. https://www.ncbi.nlm.nih.gov/pubmed/28387209

Obasi, E. M., Brooks, J. J., & Cavanagh, L. (2016). The Relationship Between Psychological

Distress, Negative Cognitions, and Expectancies on Problem Drinking: Exploring a

Growing Problem Among University Students. Behav Modif, 40(1-2), 51-69.

https://doi.org/10.1177/0145445515601793

Terlecki, M. A., & Buckner, J. D. (2015). Social anxiety and heavy situational drinking: coping

and conformity motives as multiple mediators. Addict Behav, 40, 77-83.

https://doi.org/10.1016/j.addbeh.2014.09.008

24
Villarosa-Hurlocker, M. C., & Madson, M. B. (2020). A latent profile analysis of social anxiety

and alcohol use among college students. Addict Behav, 104, 106284.

https://doi.org/10.1016/j.addbeh.2019.106284

Woolman, E. O., Becker, M. M., & Klanecky, A. K. (2015). PTSD Symptoms Mediate Academic

Stress and Drinking to Cope in College Students. J Drug Educ, 45(2), 96-112.

https://doi.org/10.1177/0047237915607282

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