Alcohol Abuse and Prospective Memory in  Young Adults With and Without Childhood  Trauma: The Moderating Role of Psychological  Inflexibility

Abstract

Background

Alcohol abuse continues to be a major concern among young adults aged 18–25, contributing to a range of cognitive, emotional, and behavioural impairments. One critical area of cognitive functioning affected by alcohol is prospective memory, the ability to remember and execute intended future actions. Individuals with a history of childhood trauma are at increased risk for alcohol misuse and associated cognitive challenges. Psychological inflexibility, defined as difficulty adapting to distressing internal experiences, may further exacerbate these effects but remains underexplored as a moderating variable.

Purpose

This study aimed to examine the moderating role of psychological inflexibility in the relationship between alcohol abuse and prospective memory in young adults with and without childhood trauma.

Methods

A total of 250 young adults (125 with childhood trauma and 125 without), aged 18–25, were selected using purposive sampling from educational institutions and community centres in Delhi NCR. Participants completed standardised self-report instruments, including the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Childhood Trauma Questionnaire-Short Form (CTQ-SF), Prospective and Retrospective Memory Questionnaire (PRMQ), and Acceptance and Action Questionnaire-II (AAQ-II). Statistical analyses included descriptive statistics, Pearson correlations, independent samples t-tests, multiple regression, and moderation analysis using the PROCESS macro in SPSS.

Results

Analyses revealed significant associations among alcohol abuse, psychological inflexibility, and prospective memory difficulties. Notable group differences emerged between trauma and non-trauma participants. Psychological inflexibility moderated the relationship between alcohol abuse and prospective memory, with higher inflexibility linked to greater impairment.

Conclusion

Findings suggest that psychological inflexibility intensifies alcohol-related cognitive difficulties, highlighting its importance as a target for interventions aimed at the vulnerable youth population.

Keywords

Alcohol abuse prospective memory childhood trauma psychological inflexibility

Introduction

Alcohol abuse remains a significant global health concern among young adults aged 18–25, a critical developmental period marked by increased autonomy and risk-taking. Nearly 60% of individuals in this age group report alcohol consumption, and about 37% engage in binge drinking, patterns linked to cognitive impairments, emotional difficulties, and social dysfunction.¹ When established during emerging adulthood, these behaviours often persist and can result in long-term neurocognitive consequences.²

A domain particularly vulnerable to alcohol misuse is prospective memory, the capacity to remember and complete intended tasks in the future. This cognitive function supports everyday activities like attending appointments or taking medications. Impairments in prospective memory can disrupt academic, occupational, and social functioning.³ Laboratory research consistently shows that both acute and chronic alcohol use negatively affect prospective memory, likely via disruptions to executive functioning and attentional control.⁴ A meta-analysis by Platt et al. confirmed global impairments in prospective memory among heavy drinkers.⁵

Emerging adults face heightened demands on neurocognitive systems during this phase, making such impairments more consequential.⁶ These vulnerabilities are exacerbated in individuals with childhood trauma, which is strongly associated with long-term neurobiological alterations, particularly in the hippocampus and prefrontal cortex, leading to deficits in memory and executive control.⁷ The theory of latent vulnerability highlights how maltreatment during development increases psychiatric risk by altering neurocognitive systems.⁸ Behaviourally, trauma survivors often use alcohol to manage emotional distress, further compromising cognitive functioning.⁹

Kim et al. provided evidence that child abuse disrupts automatic emotion regulation among children and adolescents, adding to cognitive burden.¹⁰ Sweeney and Raskin (older measures) have reported that trauma-exposed young adults with alcohol misuse display diminished prospective memory performance; Zamroziewicz et al. reaffirmed that various drinking patterns significantly impair prospective memory in college students.¹¹

Research by Shin et al. demonstrates that cognitive vulnerabilities to depression mediate the link between childhood maltreatment and problematic alcohol use, contributing to memory dysfunction and emotional dysregulation.¹² This underscores the combined impact of trauma and maladaptive coping on cognitive outcomes.

Within this context, psychological inflexibility, characterised by experiential avoidance and inability to adaptively respond to internal experiences, emerges as a proposed moderator. It is a core construct in Acceptance and Commitment Therapy (ACT) and is strongly associated with psychopathology, poor emotion regulation, and elevated substance use.¹³ Bond et al. define psychological inflexibility as integral to experiential avoidance that undermines adaptive cognitive functioning.¹⁴ In trauma-exposed individuals who misuse alcohol, high inflexibility may overtax self-regulatory resources, exacerbating prospective memory impairments.¹⁵ Chawla & Ostafin’s review emphasises that experiential avoidance functions dimensionally across psychopathology and significantly relates to cognitive dysfunction.¹⁶ Meanwhile, psychological flexibility more broadly is considered foundational for emotional and cognitive resilience,¹⁷ and Aldao & Nolen-Hoeksema highlight how ineffective emotion regulation strategies contribute to cognitive and psychological difficulties.¹⁸

Although research has examined alcohol use, trauma exposure, cognitive deficits, and psychological flexibility separately, few studies integrate these variables to explore the moderating role of psychological inflexibility on the alcohol–prospective memory link, especially in trauma contexts. Agrawal & Sharma (2025) further highlight the importance of attachment styles, alcohol expectancies, and metacognitive beliefs in shaping cognitive functioning among young adults.¹⁹ To address this gap, our study investigates whether psychological inflexibility moderates the relationship between alcohol abuse and prospective memory performance, comparing individuals with and without childhood trauma.

Methods

Aim

To investigate the moderating role of psychological inflexibility in the relationship between alcohol abuse and prospective memory among young adults with and without childhood trauma.

Operational Definitions of Variables

Alcohol Abuse

Defined as engagement in hazardous drinking patterns with moderate health or psychosocial risk. Operationalised using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Participants scoring between 4 and 26 on the alcohol use domain were included, indicating moderate-risk involvement (Humeniuk et al., 2008).

Childhood Trauma

Defined as exposure to emotional, physical, or sexual abuse or neglect during early developmental periods. Measured using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Scores ≥8 on any trauma domain were used as a cut-off for trauma exposure (Bernstein et al., 2003).

Prospective Memory

Defined as the self-reported ability to remember and execute future intentions. Measured using the Prospective subscale of the Prospective and Retrospective Memory Questionnaire (PRMQ) (Crawford et al., 2003). Higher scores indicate greater impairment.

Psychological Inflexibility

Defined as the tendency to rigidly avoid or suppress internal experiences at the cost of behavioural flexibility. Measured using the Acceptance and Action Questionnaire-II (AAQ-II). Higher scores indicate greater inflexibility (Bond et al., 2011).

Objectives

To examine the descriptive statistics (mean, standard deviation, frequency, and distribution) of psychological inflexibility, prospective memory, childhood trauma and alcohol abuse among the study participants.

To examine the relationship between alcohol abuse, childhood trauma and prospective memory in young adults.

To compare alcohol abuse, childhood trauma, psychological inflexibility and prospective memory performance between individuals with and without childhood trauma.

To study the effect of childhood trauma, psychological inflexibility and alcohol abuse on prospective memory among young adults.

To assess whether psychological inflexibility moderates the relationship between alcohol abuse and prospective memory.

To assess whether psychological inflexibility moderates the relationship between childhood trauma and prospective memory.

Hypotheses

H₁: There will be a significant relationship between prospective memory, childhood trauma and alcohol abuse in young adults.

H₂ There will be significant group differences in prospective memory, alcohol abuse and psychological inflexibility among young adults with and without childhood trauma.

H₃: Childhood trauma and alcohol abuse will be a significant predictor of prospective memory.

H₄: Psychological inflexibility will moderate the relationship between alcohol abuse and prospective memory.

H₅: Psychological inflexibility will moderate the relationship between childhood trauma and prospective memory.

Study Design

This study is a quasi-experimental study in which the experimental group consisted of people with childhood trauma and the control group consisted of people without childhood trauma.

Sample Size and Sampling

Sample Size

Based on G Power analysis, a minimum sample size of 107 was required. A total of 250 participants were recruited (125 with childhood trauma and 125 without).

Sampling Technique

Purposive sampling was used to recruit participants aged 18–25 from universities and community centres in Delhi NCR.

Inclusion Criteria

Aged 18–25 years

Alcohol use in the past year

Score of 4–26 on the alcohol domain of the ASSIST

Score of ≥8 on any trauma domain of the CTQ-SF (for trauma group)

Educational attainment up to 12th grade

Exclusion Criteria

History of diagnosed psychiatric disorders

Dependence on substances other than alcohol and nicotine

Measures

PRMQ To evaluate prospective memory lapses, the PRMQ developed by Crawford et al. was used. This tool includes eight items specifically targeting prospective memory errors, asking participants how frequently they forget to carry out intended tasks. Responses are given on a 5-point Likert scale, ranging from 0 (Never) to 4 (Very Often). The prospective memory subscale has shown solid internal consistency with a Cronbach’s alpha of 0.84.²⁰

CTQ-SF The CTQ-SF, developed by Bernstein et al., assesses self-reported exposure to various types of childhood maltreatment, including emotional, physical, and sexual abuse, as well as emotional and physical neglect. The instrument contains 28 items, rated on a Likert scale that captures the frequency of each experience. It provides both subscale and overall trauma scores. The CTQ-SF has been widely validated in clinical and non-clinical samples, showing high internal consistency with Cronbach’s alpha values ranging from 0.79 to 0.94 across subscales.²¹

AAQ-II The AAQ-II, created by Bond et al., measures psychological inflexibility, conceptualised as the unwillingness to experience unwanted internal events and a failure to act in alignment with values. The tool includes seven items, rated on a 7-point scale from ‘Never True’ to ‘Always True’. Higher scores indicate greater psychological inflexibility. The AAQ-II has demonstrated acceptable psychometric properties with a Cronbach’s alpha of around 0.84.²²

ASSIST Developed by the World Health Organisation, the ASSIST is used to assess the frequency, intensity, and risk level of alcohol and other substance use. It screens for use across multiple substance domains, including alcohol, and identifies patterns indicative of hazardous use. The instrument has been validated across different cultures and populations. In the context of alcohol assessment, the ASSIST has shown good internal reliability, with a Cronbach’s alpha of 0.88.²³

Procedure

The ethical clearance was taken from the faculty of Behavioural Sciences, SGT University. Participants were informed about the purpose and the objectives of the study. Consent from the participants was taken. All participants were informed that the information shared by them would be kept confidential, and they had the right to withdraw from the study at any moment. People fulfilling the inclusion criteria were selected based on the scales, which are the CTQ-short version and ASSIST. All those who had scored 8 or more on CTQ and scored between 4 and 26 on the ASSIST Questionnaire were part of the experimental group, and those who scored less than 8 on CTQ were part of the control group. The data were collected using two questionnaires, PRMQ and AAQ-II. The obtained data were run for the statistical analysis in SPSS. The results obtained from the analysis were then interpreted.

Statistical Analysis

Data analysis was done using SPSS (version 26). Data were checked for normality using the Shapiro–Wilk test. The demographic information of the participants was summarised using Descriptive statistics. Pearson correlation was done to understand the relationship between prospective memory, psychological inflexibility, childhood trauma and alcohol abuse in young adults. t-test was used to analyse group differences in prospective memory, psychological inflexibility and alcohol abuse among individuals with and without childhood trauma. Multivariate Regression was used to understand the effect of psychological inflexibility, alcohol abuse and childhood trauma on prospective memory. Moderation Analysis was done using the PROCESS macro for SPSS (Hayes, 2013) to test the moderating effects of psychological inflexibility in the relationship between childhood trauma and alcohol abuse with prospective memory.

Results

Sociodemographic Characteristics of the Participants

Table 1 presents the descriptive statistics for continuous sociodemographic variables of young adults who reported alcohol use. The mean age of the participants was 22 years (SD = 2.10), indicating that the sample comprises individuals in late adolescence and early adulthood. The minimum age was 18 years, and the maximum was 25 years, consistent with the study’s inclusion criteria for young adults. The average family income was 800,000 INR per year, with a standard deviation of 200,000 INR, reflecting moderate variation in socioeconomic level. In terms of educational attainment, participants reported an average of 15 years of formal education, which implies that most had completed high school and were either pursuing or had completed undergraduate studies. These continuous variables help contextualise the background characteristics of the sample and offer insight into potential correlates of alcohol use among educated, urban young adults.

Table 1.

Shows Descriptive Statistics of Age, Family Income, and Education Among Young Adults Using Alcohol (N = 250).

Demographic Variable	Mean	SD	Minimum	Maximum
Age	22	2.097	18	25
Family income	800,000	200,000	500,000	1400,000
Education in years	15	14	14	18

Descriptive Statistics for Psychological Variables

Table 2 summarises the key psychological variables for 250 participants. The mean alcohol abuse score was 14.87 (SD = 3.98), indicating moderate risk. The average trauma score was 55.43 (SD = 20.53), with emotional neglect and emotional abuse showing the highest subscale means. Prospective memory had a mean of 17.34 (SD = 6.02), suggesting moderate variability in cognitive functioning. Psychological inflexibility averaged 19.84 (SD = 10.53), reflecting a broad range of experiential avoidance. These results highlight the relevance of trauma, memory, and inflexibility in the sample.

Table 2.

Shows Descriptive Statistics of Alcohol Use, Childhood Trauma, Metacognitive Beliefs, Memory, Schemas and Psychological Inflexibility Among Young Adults (N = 250).

Descriptive Statistics
	N	Mean	Minimum	Maximum	SD
Alcohol abuse	250	14.87	10	28	3.979
Trauma total	250	55.43	26	140	20.531
Prospective memory	250	17.34	8	37	6.022
Emotional abuse	250	9.03	5	25	4.842
Physical abuse	250	6.984	5	25	3.9372
Sexual abuse	250	7.62	5	25	4.358
Emotional neglect	250	13.68	5	25	8.068
Physical neglect	250	9.88	5	25	3.852
Denial	250	8.18	4	25	4.143
Psychological inflexibility	250	19.84	3	49	10.525

Frequency Distribution of Trauma Exposure and Subtypes

Among the 250 participants, 52.8% were categorised into the trauma group, while 47.2% reported no trauma. Trauma severity was nearly evenly split, with 52.4% reporting low and 47.6% high trauma. Neglect-related experiences were most prevalent, with emotional neglect (54.0%) and physical neglect (56.0%) reported more frequently than abuse subtypes. Emotional abuse was reported by 34.8%, sexual abuse by 26.8%, and physical abuse by 18.8%. Additionally, 43.6% showed denial responses, indicating a tendency to minimise trauma, which may impact the accuracy of self-reported data. These findings highlight the complex and often underrecognised nature of childhood trauma in this population.

Correlations Between Psychological Inflexibility, Alcohol Abuse and Childhood Trauma

Table 3 presents Pearson correlations between psychological inflexibility, alcohol abuse, and trauma dimensions. Psychological inflexibility was positively correlated with alcohol abuse (r = 0.325, p < .01), total trauma (r = 0.243, p < .01), emotional abuse (r = 0.507, p < .01), physical abuse (r = 0.418, p < .01), and sexual abuse (r = 0.434, p < .01), indicating greater inflexibility is linked to higher trauma and alcohol use. Emotional neglect showed no significant correlation (r = –0.050, ns), while denial was negatively correlated (r = –0.193, p < .01). High intercorrelations among trauma subtypes (e.g., emotional and physical neglect: r = 0.823, p < .01) highlight their overlap. All results were bootstrapped with 10,000 samples. a robust method recommended when assumptions of normality are violated (Field, 2018).²⁴

Table 3.

Shows Pearson Correlations Between Psychological Inflexibility, Alcohol Abuse, and Childhood Trauma Dimensions (N = 250).

Correlations
	1	2	3	4	5	6	7	8	9
Psychological inflexibility	1
Alcohol abuse	0.325^**	1
Trauma total	0.243^**	0.627^**	1
Emotional abuse	0.507^**	0.540^**	0.665^**	1
Physical abuse	0.418^**	0.460^**	0.521^**	0.671^**	1
Sexual abuse	0.434^**	0.460^**	0.566^**	0.616^**	0.454^**	1
Emotional neglect	−0.050	0.383^**	0.805^**	0.209^**	0.043	0.183^**	1
Physical neglect	0.052	0.472^**	0.859^**	0.404^**	0.218^**	0.286^**	0.823^**	1
Denial	−0.193^**	0.289^**	0.643^**	−0.007	−0.046	0.066	0.801^**	0.670^**	1

Notes: **Correlation is significant at the 0.01 level (2-tailed).

Bootstrapped with 10,000 samples.

Independent Samples t-test for Trauma and  Non-trauma Groups

Table 4 presents independent samples t-test results comparing individuals with and without trauma exposure across key psychological variables. Participants in the trauma group scored significantly higher on alcohol abuse, total trauma, all five trauma subtypes (emotional, physical, sexual abuse, emotional and physical neglect), denial, and psychological inflexibility, with all differences reaching statistical significance (p < .05). Notably, the trauma group showed elevated levels of emotional neglect and emotional abuse, as well as higher psychological inflexibility scores (M = 21.41, SD = 11.16) compared to the non-trauma group (M = 18.08, SD = 9.50). In contrast, no significant group differences were observed for prospective memory or retrospective memory. These results suggest that trauma exposure is more strongly associated with emotional dysregulation and maladaptive psychological patterns than with memory-related functioning.

Table 4.

Shows Group Comparison Between Individuals With and Without Trauma (N = 250).

Variables	Trauma Group  n = 118 Mean ± SD	Without Trauma Group  n = 132 Mean ± SD	t (df = 248)	p Value
Alcohol abuse	16.83 ± 3.57	12.69 ± 3.20	−9.597	.000**
Trauma total	73.44 ± 10.04	35.29 ± 3.03	−39.687	.000*
Prospective memory	17.84 ± 5.70	16.79 ± 6.35	−1.382	.672
Retrospective memory	16.61 ± 5.58	15.22 ± 6.30	−1.853	.395
Emotional abuse	11.48 ± 5.57	6.29 ± 0.90	−10.002	.000**
Physical abuse	8.16 ± 5.06	5.67 ± 1.00	−5.251	.000**
Sexual abuse	9.42 ± 5.34	5.62 ± 0.92	−7.629	.000**
Emotional neglect	20.44 ± 4.98	6.11 ± 1.21	−30.484	.000**
Physical neglect	12.98 ± 2.61	6.41 ± 0.99	−25.758	.001**
Denial	10.84 ± 3.94	5.19 ± 1.47	−14.672	.000**
Psychological inflexibility	21.41 ± 11.16	18.08 ± 9.50	−2.520	.045**

Notes: *p < .05 (significant), **p < .01 (significant).

Bootstrapped with 10,000 samples.

Stepwise Multiple Linear Regression Predicting Memory Functioning

Table 5 presents a stepwise multiple regression analysis examining predictors of memory performance. In the first step, psychological inflexibility significantly predicted poorer memory functioning, accounting for 7.1% of the variance (R² = 0.071, F(1, 248) = 18.99, p < .001). In the second step, childhood trauma added a small but significant contribution (∇R² = 0.015), increasing the explained variance to 8.6% (R² = 0.086, F change = 11.60, p = .047). Psychological inflexibility remained the stronger predictor (β = 0.236) compared to trauma (β = 0.125). Bootstrapping with 10,000 samples confirmed the robustness of these findings. Overall, both factors were significant but modest predictors of memory difficulties.

Table 5.

Shows Stepwise Multiple Linear Regression Predicting Memory from Psychological Inflexibility and Childhood Trauma  (N = 250).

Multiple Linear Regression
Model	Predictor	R	R Square	SE	B	Beta	t	f	df	Sig.
1	Psychological inflexibility	0.267	0.071	0.068	0.255	0.236	3.767	18.99	1/248	0.000**
2	Childhood trauma	0.7293	0.086	0.035	0.069	0.125	1.996	11.60	1/247	0.047*

Notes: Predictors: (Constant), PI, Childhood Trauma.

Dependent Variable: Memory.*p < .05 (significant), **p < .01 (significant).

Moderation Analysis: Trauma and Psychological Inflexibility Predicting Memory

Tables 6 –8 present the results of a moderation analysis assessing whether psychological inflexibility moderates the relationship between trauma and memory performance. The overall model was significant (R² = 0.11, F(3, 246) = 10.32, p < .001), accounting for 11% of the variance in memory scores. Trauma significantly predicted lower memory performance (B = −0.23, p = .035), while psychological inflexibility alone was not a significant predictor (B = −6.06, p = .132). However, the interaction between trauma and psychological inflexibility was significant (B = 0.20, p = .004), indicating a moderating effect. Specifically, higher psychological inflexibility intensified the negative impact of trauma on memory. The interaction term contributed an additional 3% to the explained variance (∇R² = 0.03, F = 8.66, p < .001), confirming that the trauma–memory relationship is conditional on inflexibility levels.

Table 6.

Shows the Model Summary for the Moderation Analysis Assessing Whether Psychological Inflexibility Moderates the Relationship Between Trauma and Memory.

Model Summary
R	R ²	MSE	F	df1	df2	p
0.33	0.11	115.99	10.32	3.00	246.00	.00**

Note: *p < .05 (significant), **p < .01 (significant).

Table 7.

Shows the Regression Coefficients for the Main Effects and Interaction Term in the Moderation Model

Coefficient
	Coefficient	SE	T	p	95% CI [LL, UL]
Constant	38.22	6.19	6.18	.000**	[26.04, 50.40]
Trauma (X)	−0.23	0.11	−2.12	.035*	[−0.45, −0.02]
Psychological inflexibility (W)	−6.06	4.02	−1.51	.132**	[−13.98, 1.86]
Trauma × PI_G (interaction)	0.20	0.07	2.94	.004**	[0.07, 0.33]

Note: *p < .05 (significant), **p < .01 (significant).

Table 8.

The Change in R² for the Interaction Term, Testing Its Contribution to the Model Above and Beyond the Main Effects.

Test of Highest-order Unconditional Interaction(s)
Interaction	R² Change	F	df1	df2	p
Trauma × PI	.03	8.66	1	246.00	.00**

Note: *p < .05 (significant), **p < .01 (significant).

Moderation Analysis: Alcohol Abuse and Psychological Inflexibility Predicting Memory

Table 9 shows that the overall moderation model was significant (R² = 0.10, F(3, 246) = 8.88, p < .001), explaining 10% of the variance in memory performance. While alcohol abuse (B = −1.05, p = .100) and psychological inflexibility (B = −7.79, p = .167) were not individually significant, their interaction was (B = 0.87, p = .020), indicating a moderating effect. Table 10 shows The interaction of alcohol abuse and psychological inflexibility significantly predicted memory (B = 0.87, p = .020), while their individual effects were non-significant. As confirmed in Table 11, the interaction accounted for an additional 2% of variance (∇R² = 0.02, F = 5.46, p = .020). These results suggest that higher psychological inflexibility increases vulnerability to memory impairments associated with alcohol abuse. The findings underscore the clinical importance of addressing both alcohol use and cognitive rigidity in intervention strategies.

Table 9.

Shows Model Summary for Moderation Analysis Examining Alcohol Abuse and Psychological Inflexibility as Predictors of Memory.

Model Summary
R	R ²	MSE	F	df1	df2	p
0.31	0.10	117.83	8.88	3.00	246.00	.00**

Table 10.

Shows Unstandardised Regression Coefficients for Moderation Predicting Memory.

Coefficient
	Coefficient	SE	t	p	95% CI [LL, UL]
Constant	40.86	9.14	4.47	.000**	[22.86, 58.87]
Alcohol abuse (X)	−1.05	0.63	−1.67	.100	[−2.29, 0.19]
Psychological inflexibility (W)	−7.79	5.62	−1.39	.167	[−18.86, 3.28]
Interaction (X × W)	0.87	0.37	2.34	.020**	[0.14, 1.60]

Note: *p < .05 (significant), **p < .01 (significant).

Table 11.

Shows Test of Highest-order Unconditional Interaction in Moderation Model Predicting Memory.

Test of Highest-order unconditional Interaction(s)
Interaction	R² Change	F	df1	df2	p
Alcohol× PI	.02	5.46	1	246	.02*

Note: *p < .05 (significant), **p < .01 (significant).

Discussion

The present study explored the complex interplay between psychological inflexibility, alcohol abuse, and childhood trauma in predicting prospective memory functioning among young adults. Understanding the cognitive impact of trauma and alcohol use in young adults is critical, especially during emerging adulthood, a period of heightened neuroplasticity and behavioural vulnerability. As outlined by Arnett (2000), this stage involves increased autonomy but also elevated risk for substance misuse and impaired self-regulation.²⁵

The findings of this study support the conceptual framework of experiential avoidance and cognitive-affective vulnerability models, where psychological inflexibility hinders adaptive functioning in the presence of stress or trauma. Hayes et al. (2012) argue that psychological inflexibility, the inability to tolerate distressing internal experiences, can intensify both emotional and cognitive disturbances.²⁶

In line with Objective 1, descriptive analysis indicated that emotional neglect and abuse were the most frequently reported trauma subtypes, consistent with previous evidence from Teicher and Samson (2016), who found that neglect is often underrecognised yet highly detrimental to neural and emotional development.²⁷

Objective 2 and H₁ were supported through significant correlations among trauma, alcohol use, and psychological inflexibility. Levin et al. (2013) emphasise that inflexibility often co-occurs with maladaptive coping strategies, such as alcohol misuse, particularly in trauma-exposed individuals.²⁸

In relation to Objective 3, t-test analyses revealed significant group differences across alcohol use, trauma indicators, and inflexibility, but not for prospective memory, partially rejecting H₂. According to McCrory and Viding (2015), trauma may not directly impair cognition unless accompanied by chronic dysregulation or contextual stressors.²⁹

Supporting Objective 4 and H₃, stepwise regression confirmed that psychological inflexibility was a stronger predictor of memory performance than trauma exposure. Bond et al. (2011) found that inflexibility undermines attentional and executive processes, which are vital to prospective memory tasks.³⁰

The most notable findings addressed Objectives 5 and 6. Moderation analyses showed that psychological inflexibility significantly strengthened the negative relationship between both trauma and alcohol use with prospective memory, confirming H₄ and H₅. Chawla and Ostafin (2007) note that individuals who avoid emotional discomfort often show greater cognitive impairments under stress, supporting the observed interaction effects.³¹

From a clinical standpoint, these results highlight the importance of targeting not just behavioural outcomes like substance use, but also underlying cognitive-emotional rigidity. Twohig and Levin (2017) have demonstrated that ACT, which enhances psychological flexibility, is effective in reducing both substance use and cognitive impairment.³²

Despite its strengths, this study has limitations. The cross-sectional design restricts causal inferences, and the reliance on self-reported memory may underrepresent actual performance. Future research should incorporate objective cognitive tasks and longitudinal designs to track changes over time. Brown and Tapert (2004) suggest that adolescence-to-adulthood trajectories of alcohol use are better captured using such developmental methodologies.³³

Expanding future models to include mediators such as emotional regulation or metacognitive beliefs could further explain how trauma and inflexibility interact to impair memory. As Spada et al. (2015) indicate, beliefs about cognitive control may serve as mechanisms through which psychological inflexibility translates into memory dysfunction.³⁴

Conclusion

This study underscores the central role of psychological inflexibility in moderating the cognitive effects of childhood trauma and alcohol abuse. While trauma and substance use each contribute to prospective memory difficulties, their negative impacts are amplified in individuals exhibiting higher psychological rigidity. These findings provide a foundation for integrating flexibility-focused interventions in youth mental health and substance use programmes, with a view toward enhancing cognitive resilience and functional outcomes.

Footnotes

Acknowledgements

This research was conducted in accordance with ethical standards and guidelines. The authors acknowledge the participants who contributed to this study for their time and cooperation. No external writing or editing assistance was used in preparing this manuscript.

Authors’ Contribution

Shivangi Agrawal: Conceptualisation, data collection, manuscript preparation, methodology development.

Vikas Sharma: Critical revision, supervision and approval of the final manuscript.

Consent to Participate

Informed consent was obtained from all participants prior to their inclusion in the study.

Consent for Publication

Not applicable, as this manuscript does not include any identifiable personal data, images, or videos.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Data Availability

Data supporting the findings of this study are available upon reasonable request from the corresponding author.

Funding

The authors received no financial support for the research, authorship and/or publication of this article.

Statement of Ethics

This study was conducted following the ethical guidelines of the Indian Council of Medical Research (ICMR) and the Declaration of Helsinki. Ethics approval was granted by the Ethics Committee, SGT University (Shree Guru Govind Singh Tricentenary University), approval number [SGTU/FBSC/ECC/2024/33].

ORCID iD

Shivangi Agrawal

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Alcohol Abuse and Prospective Memory in Young Adults With and Without Childhood Trauma: The Moderating Role of Psychological Inflexibility

Abstract

Background

Purpose

Methods

Results

Conclusion

Keywords

Introduction

Methods

Aim

Operational Definitions of Variables

Alcohol Abuse

Childhood Trauma

Prospective Memory

Psychological Inflexibility

Objectives

Hypotheses

Study Design

Sample Size and Sampling

Sample Size

Sampling Technique

Inclusion Criteria

Exclusion Criteria

Measures

Procedure

Statistical Analysis

Results

Sociodemographic Characteristics of the Participants

Shows Descriptive Statistics of Age, Family Income, and Education Among Young Adults Using Alcohol (N = 250).

Descriptive Statistics for Psychological Variables

Shows Descriptive Statistics of Alcohol Use, Childhood Trauma, Metacognitive Beliefs, Memory, Schemas and Psychological Inflexibility Among Young Adults (N = 250).

Frequency Distribution of Trauma Exposure and Subtypes

Correlations Between Psychological Inflexibility, Alcohol Abuse and Childhood Trauma

Shows Pearson Correlations Between Psychological Inflexibility, Alcohol Abuse, and Childhood Trauma Dimensions (N = 250).

Independent Samples t-test for Trauma and Non-trauma Groups

Shows Group Comparison Between Individuals With and Without Trauma (N = 250).

Stepwise Multiple Linear Regression Predicting Memory Functioning

Shows Stepwise Multiple Linear Regression Predicting Memory from Psychological Inflexibility and Childhood Trauma (N = 250).

Moderation Analysis: Trauma and Psychological Inflexibility Predicting Memory

Shows the Model Summary for the Moderation Analysis Assessing Whether Psychological Inflexibility Moderates the Relationship Between Trauma and Memory.

Shows the Regression Coefficients for the Main Effects and Interaction Term in the Moderation Model

The Change in R² for the Interaction Term, Testing Its Contribution to the Model Above and Beyond the Main Effects.

Moderation Analysis: Alcohol Abuse and Psychological Inflexibility Predicting Memory

Shows Model Summary for Moderation Analysis Examining Alcohol Abuse and Psychological Inflexibility as Predictors of Memory.

Shows Unstandardised Regression Coefficients for Moderation Predicting Memory.

Shows Test of Highest-order Unconditional Interaction in Moderation Model Predicting Memory.

Discussion

Conclusion

Footnotes

Acknowledgements

Authors’ Contribution

Consent to Participate

Consent for Publication

Declaration of Conflicting Interests

Data Availability

Funding

Statement of Ethics

ORCID iD

References

Alcohol Abuse and Prospective Memory in  Young Adults With and Without Childhood  Trauma: The Moderating Role of Psychological  Inflexibility

Independent Samples t-test for Trauma and  Non-trauma Groups

Shows Stepwise Multiple Linear Regression Predicting Memory from Psychological Inflexibility and Childhood Trauma  (N = 250).