Mental and Social Health Commons^™

The Mediating Role Of Hope In The Relationship Between Everyday Discrimination And Depression Among College Students, Busra Vurkun

Counseling & Human Services Theses & Dissertations

Research shows that marginalized populations experience disproportionately higher psychological distress (Budhwani et al., 2015; Bailey et al., 2019). Everyday discrimination, defined as chronic interpersonal mistreatment such as microaggressions and disrespect, is associated with greater depression and lower psychological well-being (Essed, 1991; Calabrese et al., 2015). Although the negative effects of discrimination are well established, less is known about protective factors that may reduce these outcomes. One such factor is hope, conceptualized by Snyder et al. (1991) as agency thinking and pathways thinking and linked to lower depression and greater resilience (Arnau et al., 2007; Banks et al., 2008). This study …

Strategies Black Male Students With Social Anxiety Use To Persist And Succeed At Rural Community Colleges, Gwendolyn F. Houston

Educational Leadership & Workforce Development Theses & Dissertations

Social anxiety, one of the more common types of anxiety, has been linked to poor concentration, impaired performance, and lower academic achievement (BlackDeer et al., 2021; Derakshan & Eysenck, 2009; Leigh et al., 2021). This study addresses the questions: “How do Black male students with social anxiety at rural community colleges in the Southeastern United States handle both academic and non-academic challenges and cope with these stressors?” and “How do Black male students with social anxiety navigate barriers during their journey at rural community colleges in the Southeastern United States, and what strategies do they use to manage these obstacles?” …

The Association Between Prenatal Nicotine Exposure And Postpartum Depression, Reem Ali Sharaf-Alddin

Health Services Research Dissertations

Postpartum Depression (PPD) is the most common mental health complication of childbirth with 17% of women globally and 13% in the US experience PPD. The pathophysiology of PPD is not yet fully understood, with psycho-social, biological, and environmental factors, interplaying together and predisposing to PPD. One key modifiable risk factor is prenatal exposure to nicotine (PEN) including Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), and Electronic Nicotine Products (ENPs). Several studies investigated the association between prenatal ATS or SHS and PPD, however the findings were inconclusive. There is a lack of studies that assessed the overall PEN, and none of …

Counselors’ Training Needs In Effectively Engaging With Psychedelic-Assisted Therapy, Elif Bor

Counseling & Human Services Theses & Dissertations

As public and scientific interest in psychedelic-assisted therapy (PAT) continues to grow, counselors are increasingly encountering clients who are exploring or engaging in psychedelic use for therapeutic purposes. Such encounters introduce new ethical, clinical, and professional considerations. Counselors must develop an informed understanding of psychedelics and their effects, recognize the emotional and cognitive processes that may emerge during psychedelic experiences, and be prepared to respond to potential risks or adverse reactions (Aicher et al., 2025). They also need to competently answer client questions, assess risk and suitability, facilitate the integration of psychedelic experiences, and collaborate with medical and other professionals …

Exploring The Experiences Of Women In Mental Health Therapy After The Occurrence Of Perinatal Loss, Courtney Allison Nishnick

Counseling & Human Services Theses & Dissertations

Perinatal loss encompasses losses of pregnancies at any gestational age, as well as deaths occurring within one year post-birth. In the United States, around 40 thousand stillbirths and infant deaths occur every year (Ely & Driscoll, 2025; Gregory et al., 2025), with about 23 million miscarriages also occurring annually worldwide (Quenby et al., 2021). Perinatal loss experiences lead to distressing mental health symptoms not limited to anxiety, depression, posttraumatic stress, and grief (Crockett et al., 2019; Wamser & Ferro, 2025). While there is extensive research on perinatal loss as it pertains to medical context, there is minimal research relating to …

From Invisible Injury To Measurable Impact: Exploring Associations Between Peripheral Biomarkers Of Neuroinflammation And Mental Health Outcomes After Mtbi, Lauren Leggett Smith

Psychology Theses & Dissertations

Mild traumatic brain injury (mTBI), often referred to as a “silent epidemic,” accounts for the majority of traumatic brain injuries worldwide and is increasingly linked to persistent psychiatric outcomes. Despite its prevalence, mTBI remains understudied due to diagnostic challenges, underreporting, and misperceptions of its clinical significance. The present study examined whether peripheral biomarkers of neuroinflammation and astroglial injury—tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and glial fibrillary acidic protein (GFAP)— mediate associations between mTBI history and psychiatric symptom severity, including depression, anxiety, and posttraumatic stress disorder (PTSD). Participants were 138 traumaexposed adults recruited from an urban university and surrounding community, with …

Ptsd Symptoms And Cannabis Use Among College Students: Examining The Role Of Trauma-Related Cannabis Use To Cope, Christopher T. Latourrette

Psychology Theses & Dissertations

Individuals with posttraumatic stress disorder (PTSD) are more than four times as likely to develop cannabis use disorder (CUD) as those without PTSD. This common co-occurrence is often interpreted through a self-medication framework in which cannabis is used to manage PTSD symptoms. Prior work has relied heavily on veteran samples, includes measures of cannabis coping that are not specific to PTSD, and has most commonly examined total PTSD symptom severity, limiting precision in understanding how discrete symptom clusters relate to cannabis outcomes. The present study sought to examine associations between individual PTSD symptom clusters and cannabis use severity and to …

"On The Same Rope": An Exploratory Study Of Staff Experiences At The Mountain Seed Foundation's Healing Base Camp Program, Jill C. Kivikoski

Counseling & Human Services Theses & Dissertations

Since the escalation of Russia’s invasion of Ukraine in 2022, Ukrainians have faced significant social and public health challenges, particularly among Service Members, Veterans, and their Families (SMVF), including disability, traumatic stress, and barriers to mental health care (Kostenko et al., 2024; Krasnodemska et al., 2023; O’Grady & Galouchka, 2023). Retreat based programs grounded in shared military identity may offer an accessible form of support (Barrett & Currin, 2024). Mountain Seed Foundation’s (MSF) Healing Base Camp (HBC) was developed to promote healing and resilience among Ukrainian SMVF (Mountain Seed Foundation, n.d.).

This qualitative dissertation used a single-case study design (Yin, …

The Effects Of Covid 19 Job Demands On Public Sector Employees’ Organizational Commitment: The Mediating Roles Of Work Engagement And Job Burnout, And The Moderating Role Of Supervisor Support, Benjamin R. Kaufman

Psychology Theses & Dissertations

United States citizens rely on state government employees to provide essential public services. During the COVID-19 pandemic, these employees responded by administering both routine and novel procedures to protect public health, often placing them on the frontlines and at increased risk of contagion. Concurrently, the pandemic-driven economic downturn created budget shortfalls that threatened the job and financial security of the state workforce. Together, these conditions substantially increased job demands for state government employees.

Guided by the Job Demands–Resources (JDR) Model, this study examined how COVID‑19-related job demands influenced state employees’ work engagement, job burnout, and organizational commitment, and whether supervisor …

Factors For Successful Craniosynostosis Surgery Gofundme Campaigns, Annarose Taylor, Rena Atayeva, Shikha Trivedi, Phavon Sage, David Park, Brendan Podszus, Jessica Bigner, Yifan Guo

Knowledge and Creativity Expo

Introduction

Craniosynostosis surgery costs can be as high as 100,000 dollars. Even with complete insurance coverage, patients often face large out-of-pocket expenses. Thus, patients seek other financial resources. As a crowdfunding platform, GoFundMe (GFM) is one of those resources. The objective of our study was to identify GFM campaign factors associated with greater fundraising success.

Methods

GoFundMe.com was queried for: craniosynostosis, synostosis, brachycephaly, trigonocephaly, scaphocephaly, and fused skull suture. Included campaigns had patients in the U.S. fundraising for craniosynostosis surgery or related expenses. Excluded campaigns were duplicates, for animals, helmets, charities, or other surgeries. Successful campaigns achieved third quartile of …

Exploring The Relationship Between Behavioral Health Early Prediction Model And Patient Outcomes In The Emergency Department, Karen M. Richendollar, Kathie M. Zimbro

Knowledge and Creativity Expo

Problem: Emergency departments (EDs) are increasingly utilized for mental health (MH) care, often resulting in overcrowding and delayed access to specialized services. A significant proportion of MH patients are discharged without a psychiatric consult, raising concerns about safety and readmission rates. This trend places additional strain on already limited behavioral health resources and contributes to care delays for patients in acute crisis. Moreover, the lack of standardized discharge criteria for MH patients increases variability in care and may compromise patient outcomes. Purpose: This study evaluates the effectiveness of the Behavioral Health Early Discharge Prediction Model (BHEDPM) in identifying MH patients …

The Phoenix Trauma Response Model (Ptrm): An Integrative And Innovative Approach To Trauma Recovery And Growth, Latesha S. Holloman, Lauren B. Robins, Tammie Willis, Courtney V. Morris

Journal of Human Services Scholarship and Interprofessional Collaboration

Trauma is increasingly understood as a developmentally consequential experience that shapes identity, regulation, and relational functioning across the lifespan. Although trauma-informed care, resilience theory, posttraumatic growth, and narrative approaches have expanded understanding of recovery, few frameworks articulate a structured developmental progression that integrates prevention, intervention, and intergenerational transformation within a unified model. The Phoenix Trauma Response Model (PTRM) addresses this gap by introducing a cyclical, phase-based framework organized around four interrelated processes: Recognition, Reframing, Reclamation, and Replication of Strength. Central to the model is the construct of conversion potential, defined as the structured capacity to translate distress into purposeful …

Bridging Theory And Self-Development In Human Services And Counselor Education, Kristy Carlisle

Journal of Human Services Scholarship and Interprofessional Collaboration

Counselor and human services education increasingly recognize self-awareness as a core component of professional competence and ethical practice. This conceptual manuscript presents a pedagogical framework that integrates major helping theories as tools for structured self-reflection and self-development among students and practitioners. Drawing from experiential learning theory, reflective practice, and models of counselor identity formation, the approach encourages learners to view themselves through theoretical lenses such as person-centered, cognitive-behavioral, and existential frameworks, paralleling the very lenses through which they will view their clients in practice. By engaging in guided reflective activities, students examine personal beliefs, emotions, and behaviors to enhance self-understanding, …

Integrating Clinical Reasoning Into Mental Health Diagnosis: A Conceptual Framework For Counseling Practice, Ashley F. Waddington, Alexander M. Fields, Haley Ault

Journal of Human Services Scholarship and Interprofessional Collaboration

Clinical reasoning has long guided diagnostic accuracy in nursing and medical fields, but its application in mental health counseling remains limited. This paper presents a conceptual diagnostic decision-making (DDM) process to embed clinical reasoning into the diagnostic process for counselors, incorporating two vital constructs: counselor self-efficacy and counselor bias (implicit and explicit). Grounded in Bandura’s theory of self-efficacy (1977) and Carvalho et al.’s (2017) clinical reasoning model, the framework highlights the cognitive, behavioral, and contextual factors that shape diagnostic decision-making in early-career counselors, including counselor biases. The paper calls for reform in counselor training, emphasizing curriculum enhancements as pathways to …

Counseling And The Neurodiversity Paradigm: A Call To Action, Emily Goodman-Scott, Rawn Boulden, Aaron Albright, Jenna Alvarez, Betsy M. Perez

Counseling & Human Services Faculty Publications

The counseling profession is rooted in prevention, wellness, mental health, and a critical social justice approach to serving historically marginalized communities, including people with disabilities. The overarching construct of disability comprises subtypes, such as neurodivergence. Given the prevalence of neurodivergent individuals worldwide (approximately 15%-20%), the counseling profession must be prepared to support this community. At the same time, there is a dearth of peer-reviewed literature on neurodiversity specifically for the counseling profession. In this article, we address a timely topic in the profession. We discuss utilizing a critical counseling lens and centering marginalized identities, such as people with disabilities; prominent …

Simulating Social Attitudes With Llms: Accuracy, Demographic Effects, And Refusal Behavior In The Sensitive Domain Of Suicide Prevention, Cristina J. Perez, Michael P. Vasquez Jr., Philippe J. Giabbanelli, Patrick Y. Wu

VMASC Publications

Large language models (LLMs) are increasingly used to simulate public opinion, yet their validity in sensitive policy domains remains underexplored. We evaluate whether LLMs can reproduce attitudes toward suicide prevention policies using 32 questions drawn from seven nationally representative U.S. surveys (2023-2025). We systematically vary demographic conditioning (race/ethnicity, gender, age, education, income, party), prompt framing (direct elicitation, respondent embodiment, specialist embodiment), and model architecture (GPT-5 Nano, DeepSeek V3.2, Meta Llama 3.1 8B, Mistral Small 24B). Across 811,560 prompts, the mean absolute error—the average gap between predicted and human response distributions—is 23 percentage points. We also find that LLM responses to …

Legislative Debate-Attributed Suicidality Among Lgbtq+ Adults: The Buffering Effect Of Community Belongingness, Keith J. Watts, Shawndaya S. Thrasher, Laneshia R. Conner, Nicole Campbell, Louis G. Baser, Dekeitra Griffin, Sydney P. Howard, Missy Spears, Justin X. Moore

Counseling & Human Services Faculty Publications

Background: In recent years, the sociopolitical landscape in the United States has shifted due to an increase in state-level legislation regarding LGBTQ+ rights, a trend that has been particularly pronounced in the Commonwealth of Kentucky. While the mental health impacts of enacted laws are increasingly documented, a critical gap remains in understanding the psychological toll of the legislative debates themselves—the prolonged periods of public discourse surrounding the restriction of rights. Methods: Utilizing data from the 2025 Queer Kentucky Survey (N = 817), this exploratory study examined the association between LGBTQ+ community belongingness and acute suicidality attributed specifically to anti-LGBTQ+ legislative …

Editorial For Issue 20(2), Jeff Moe, Peighton Corley, Aaron Albright

Counseling & Human Services Faculty Publications

[Introduction] Hello to the readers of the Journal of LGBTQ Issues in Counseling. Like many counselors, counselors-in-training, scholars, and other individuals you may be coming to the journal looking for insights into your counseling work. Along with publishing original research that creates space for exploring LGBTQ+ lifeways from an open and affirmative perspective, the manuscripts published in the journal have always been grounded in application.

The Asymmetric Effect Of Social Connection And The Cumulative Damage Of Comorbidities On Physical And Mental Health Of Older Virginians, Newton Ochoki, Lynn Wiles, Peijia Zha, Vince Falco, Carielle Joy Rio, Jonathan Romero, Leorey N. Saligan

Ellmer School of Nursing Faculty Publications

Objectives

This study explored relationships of social connection with physical and mental health in older adults, specifically examining the effects of comorbidities on these relationships and the influence of sociodemographic variables on the strength of these associations.

Methods

This cross-sectional study enrolled 174 community-dwelling adults aged 60 years and older residing in Hampton Roads, Virginia, USA. Data were collected from April to August 2025. Hierarchical linear regression analyses examined the associations of social connection with physical and mental health. Moderated mediation analysis examined if comorbidities mediated these relationships and whether sociodemographic factors moderate the strengths of these associations.

Results

In …

Vape Counseling At Pediatric Practices: The Rethink Vape Toolkit, Paul T. Harrell, Ann L. Edwards, Natasha K. Sriraman, Rebecca J. Slimak, Anisha S. Vanka, Amy C. Paulson, Kelli J. England

Department of Pediatrics Faculty Publications

Introduction:

E-cigarettes (Vapes) represent the most common form of tobacco used by adolescents, with one out of every 29 (3.5%) middle school students and one in every 13 (7.8%) of high school students vaping daily. This project aimed to increase vape screening and prevention education in youth visits at pediatric practices, to increase provider comfort with the topic of vaping, and to evaluate this educational process.

Methods:

A provider training and resource modules (talking points, billing codes, and shareable parent/teen-tailored resources) were developed. Providers (N = 32) completed an anonymous pre/postsurvey regarding their knowledge, comfort levels, barriers, and practices related …

Gender Differences In The Association Between Adverse Childhood Experiences And Drug Use: Findings From A Community-Based Survey In China, Hongyun Fu, Elizabeth Monk-Turner, Xiushi Yang

Department of Pediatrics Faculty Publications

Background

While adverse childhood experiences (ACEs) are widely recognized risk factors for behavioral health problems, including drug use, prior research has largely been conducted in Western countries, focused primarily on males, and relied on convenience samples without comparison groups of nonusers. Limited work has examined the impact of ACEs on drug use in non-Western contexts. This study examines gender differences in the relationship between ACEs and drug use in China, using data from a population-based probability sample survey.

Methods:

Cross-sectional data were collected in 2019 from one city in Yunnan Province in Southwest China and one city in Guangdong Province …

Cocaine Upregulates Microglial Lipid Droplet Formation Through Increasing Lipid Synthesis Activity In Vitro And In Vivo, Yan Cheng, Brooke Russell, Liam Liyang Guo, Aryan Patel, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

A novel subtype of microglia, lipid droplet accumulation microglia (LDAMs), has been identified in the aged brain, which is characterized by sustained inflammation and senescent-like phenotypes. LDAMs are deeply involved in promoting brain aging as well as the pathogenesis of multiple neurodegenerative diseases. Cocaine can alter brain lipidomic profiles, induce microglial activation, and accelerate brain aging. This suggests that cocaine might affect microglial lipid metabolism, which ultimately aggravates aging-related neurological disorders in people with addictions. In this study, we explored the effects of cocaine on microglial lipid metabolism. Our results showed that chronic cocaine administration altered brain lipid profiles and …

The Interplay Between Loneliness, Cortisol, And Nk Cell Function: The Role Of Cortisol In Nk Cell Dysfunction, Abhinav Saurabh, Yvonne Baumer, Laurel G. Mendelsohn, Elizabeth M. Aquino Peterson, Dana Sadler, Shirley J. Lopez De Leon, Ayushi Dave, Andrew S. Baez, Lola R. Ortiz-Whittingham, Mario A. Pita, Manuel A. Cintron, Hannatu A. Tarfa, Sandy T. Reynolds, Shelby R. Hicks, Sonal Sharda, J. Eleanor Seo, Maria Lopez-Ocasio, Pradeep K. Dagur, Skyler A. Kuhn, Neelam R. Redekar, James F. Troendle, Ayanna L. Wells, Marie Marah, Katherine J. Tolentino, Michael J. Corley, Alika K. Maunakea, Lynnette K. Nieman, Marcus R. Andrews, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

Chronic psychosocial stressors contribute to cardiovascular disease (CVD) and related risk factors, particularly in under-resourced communities. Psychosocial stressors activate the hypothalamic-pituitary-adrenal (HPA) axis, leading to sustained cortisol action on immune cells. Natural killer (NK) cells are altered in distribution and function in cardio-metabolic diseases; however, pathways linking cortisol as a marker of chronic stress to NK cell dysfunction remain understudied. We recruited 186 African American women from the Step It Up Community-Engaged, Digital Health Physical Activity Intervention study and collected cortisol, NK cell measures, and psychosocial stress measures using validated questionnaires, including chronic stress and loneliness. Plasma cortisol levels were …

The Effects Of Abused Drugs On Ferroptosis Pathways: Potential Therapeutic Targets For Substance Use Disorders, Tamara Bouchard, Brooke Russell, Liam Liyang Guo, Tina Nguyen, Yan Cheng, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

Substance use disorders (SUDs) remain major public health concerns worldwide, particularly in developed countries. SUDs are characterized by persistent neuroinflammation and synaptic dysfunction in the brain. Despite decades of extensive investigation, the detailed mechanisms underlying SUDs remain elusive. Ferroptosis is a highly regulated cell death process deeply affected by iron metabolism, lipid peroxidation, reactive oxygen species (ROS) production, and antioxidant systems. It has been implicated in multiple neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and ischemic stroke. Recently, emerging evidence has highlighted the role of ferroptosis in drug-induced pathological changes. Various types of abused …

The Effects Of Abused Drugs On Ferroptosis Pathways: Potential Therapeutic Targets For Substance Use Disorders, Tamara Bouchard, Brooke Russell, Liam Liyang Guo, Tina Nguyen, Yan Cheng, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

Substance use disorders (SUDs) remain major public health concerns worldwide, particularly in developed countries. SUDs are characterized by persistent neuroinflammation and synaptic dysfunction in the brain. Despite decades of extensive investigation, the detailed mechanisms underlying SUDs remain elusive. Ferroptosis is a highly regulated cell death process deeply affected by iron metabolism, lipid peroxidation, reactive oxygen species (ROS) production, and antioxidant systems. It has been implicated in multiple neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and ischemic stroke. Recently, emerging evidence has highlighted the role of ferroptosis in drug-induced pathological changes. Various types of abused substances including alcohol, cocaine, …

Comparison Of Mental Illness Comorbidity Pre-Pandemic Vs. Pandemic-Era And Associations With Clinical And Demographic Characteristics For Virginia Public Hospital Inpatient Discharges With A Substance Use Disorder, Marilyn Bartholmae, Tharidu Gunawardena

Department of Medicine Faculty Publications

The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests …

[Review Of The Book The Prescription-To-Prison Pipeline: The Medicalization And Criminalization Of Pain, By M. Smirnova], Hayley Jackey

Sociology & Criminal Justice Faculty Publications

[Introduction] Smirnova’s The Prescription-to-Prison Pipeline offers a critical examination of the impacts of prescription drugs as well as the over-policing and policies created to push individuals into the carceral system rather than providing other options for assistance. Smirnova further captures the social inequalities of race and class of those encased in this pipeline. Within this understanding of the detriment that the system, medical providers, and society place on those who use substances, Smirnova’s use of interviews allows for a clear understanding of how these systems work in conjunction to uphold the pipeline.

Effects Of Differential Stress And Mental Health On Substance Use Among College Students, Avdi S. Avdija, Arif Akgul

Sociology & Criminal Justice Faculty Publications

Substance use among college students is often seen as a coping mechanism for some students who are prone to extreme stress, depression, or anxiety. Multiple forms of stress become the leading factors that push students toward substance use. This study tests the effects of college stressors, depression, and anxiety on substance use among college students. The results are based on the data that were collected using a 101-item questionnaire administered to 302 college students at a public university in the Midwest U.S.A. Using Logistic Regression as the primary data analysis technique, the findings of this study show that social stressors …

Maternal Child Maltreatment And Intimate Partner Violence: Effects On Perceptions Of Infant Temperment And The Mediating Role Of Emotion Regulation And Responsiveness, Jewelian N. Fairchild, G. Anne Bogat, Amy K. Nuttall, Alytia A. Levendosky, Joseph S. Lonstein, Maria Muzik

Psychology Faculty Publications

Purpose

Maternal adverse experiences, such as maltreatment in childhood and later intimate partner violence (IPV) during pregnancy, can disrupt the mother-child relationship and influence maternal perceptions of infant temperament. The present study explored how these adversities influence mothers’ views of their infants’ temperaments and examined the role of maternal emotion regulation and responsiveness to their infants as mediators of these relationships.

Methods

Using data from a longitudinal study of highly stressed, vulnerable women, 355 mothers retrospectively reported on their own childhood maltreatment, as well as their experiences of IPV and emotion regulation during pregnancy. Maternal responsiveness was coded using mother-infant …

Advancing Models Of Ptsd-Aud Comorbidity: Protocol For A Multimethod Framework Using Genetics And Ecological Momentary Assessment, Elizabeth A. Stinson, Samhita Lellapalli, Sage E. Hawn, Natalie Merrill, Lance M. Rappaport, Christina M. Sheerin, Vasiliki Michopoulos, Silviu-Alin Bacanu, Roseann E. Peterson, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which are moderately heritable, frequently co-occur and contribute to significant public health burdens, particularly among economically disadvantaged urban communities. There are noted sex differences in PTSD and AUD outcomes, with evidence suggesting women have heightened susceptibility to stress-related alcohol use. Preliminary PTSD-AUD ecological momentary assessment (EMA) findings support bidirectional associations across clinical outcomes. However, no studies to date have used PTSD-AUD comorbidity models as organizing frameworks to examine the temporal ordering and stability of within-person symptom dynamics underlying the maintenance or exacerbation of PTSD and AUD symptoms, including bidirectional and …