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(PsycINFO Database Record (c) 2020 APA, all rights reserved).OBJECTIVE We investigate if posttraumatic stress disorder (PTSD) symptoms mediate the effects of disaster severity or prior trauma on binge drinking following disaster exposure and test if support from caregiver moderates the relation between disaster severity and PTSD symptoms as well as prior trauma and PTSD symptoms. METHOD A population-based clinical trial used address-based sampling to enroll 1,804 adolescents and parents from communities affected by tornadoes in Missouri