Coffey Scott F, Saladin Michael E, Drobes David J, Brady Kathleen T, Dansky Bonnie S, Kilpatrick Dean G
Department of Psychiatry, State University of New York at Buffalo, Buffalo General Hospital, 80 Goodrich Street, Buffalo, NY 14203, USA.
Drug Alcohol Depend. 2002 Jan 1;65(2):115-27. doi: 10.1016/s0376-8716(01)00157-0.
Although the high comorbidity of posttraumatic stress disorder (PTSD) and substance use disorders has been firmly established, no laboratory-based studies have been conducted to examine relationships between the two disorders. Using cue reactivity methodology, this study examined the impact of personalized trauma-image cues and in vivo drug cues on drug-related responding (e.g. craving) in individuals with PTSD and either crack cocaine (CD) or alcohol dependence (AD). CD and AD groups displayed reactivity to both trauma and drug cues when compared to neutral cues, including increased craving. However, the AD group was more reactive than the CD group to both classes of cues. The CD participants were more reactive to trauma-image cues if drug-related material was included in the image while the AD participants were reactive to the trauma cues regardless of drug-related content. It is hypothesized that PTSD-related negative emotion may play a relatively more important role in the maintenance of AD when compared to CD. Evidence that substance dependent individuals with PTSD report increased substance craving in response to trauma memories is offered as a potential contributing factor in the poorer substance abuse treatment outcomes previously documented in this comorbid population.
尽管创伤后应激障碍（PTSD）与物质使用障碍的高共病性已得到确凿证实，但尚未开展基于实验室的研究来检验这两种障碍之间的关系。本研究采用线索反应性方法，考察了个性化创伤图像线索和真实药物线索对患有PTSD且伴有快克可卡因（CD）或酒精依赖（AD）的个体的药物相关反应（如渴望）的影响。与中性线索相比，CD组和AD组对创伤和药物线索均表现出反应性，包括渴望增加。然而，AD组对两类线索的反应性均高于CD组。如果创伤图像中包含与药物相关的内容，CD参与者对创伤图像线索的反应性更强，而AD参与者无论创伤线索中是否包含与药物相关的内容均有反应。据推测，与CD相比，PTSD相关的负面情绪在AD的维持中可能发挥相对更重要的作用。有证据表明，患有PTSD的物质依赖个体在面对创伤记忆时报告称物质渴望增加，这被认为是先前记录的该共病群体中物质滥用治疗效果较差的一个潜在促成因素。
