Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
Depress Anxiety. 2009;26(12):1158-64. doi: 10.1002/da.20637.
The co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) has been found to be associated with a range of negative clinical outcomes (e.g., relapse, suicide, legal problems, HIV infection). However, less is known about the particular factors that may be placing individuals with a co-occurring PTSD and SUD diagnosis at risk for these outcomes. The construct of risk-taking propensity may hold particular promise.
To investigate the relevance of risk-taking propensity to PTSD-SUD patients, differences in risk-taking propensity were examined among 90 crack/cocaine dependent patients in residential substance abuse treatment with (n=20) or without (n=70) a current PTSD diagnosis. Risk-taking propensity was assessed using an established behaviorally based measure, the Balloon Analogue Risk Task (BART).
Crack/cocaine dependent patients with PTSD exhibited significantly greater levels of risk-taking propensity than patients without PTSD, and this difference remained significant even when controlling for the presence of comorbid psychiatric disorders and current psychotropic medication use. No evidence was found for a different pattern of change in risk-taking propensity from the beginning to the end of the task as a function of PTSD status.
Although preliminary, results suggest the need to further investigate risk-taking propensity as a factor that may be associated with the negative clinical outcomes observed among crack/cocaine users with PTSD.
创伤后应激障碍（PTSD）和物质使用障碍（SUD）的共同发生与一系列负面临床结局（如复发、自杀、法律问题、HIV 感染）有关。然而，对于可能使 PTSD 和 SUD 共病患者面临这些结局风险的特定因素知之甚少。冒险倾向的构建可能具有特殊的意义。
为了探讨冒险倾向对 PTSD-SUD 患者的相关性，研究了 90 名住院物质滥用治疗的可卡因依赖者中冒险倾向的差异，这些患者中有（n=20）或没有（n=70）当前 PTSD 诊断。冒险倾向使用已建立的基于行为的测量方法，即气球模拟风险任务（BART）进行评估。
与没有 PTSD 的患者相比，患有 PTSD 的可卡因依赖者表现出更高水平的冒险倾向，即使控制了共病精神障碍和当前精神药物的使用，这种差异仍然显著。没有证据表明，作为 PTSD 状态的函数，从任务开始到结束，冒险倾向的变化模式不同。
尽管初步结果表明，需要进一步研究冒险倾向，因为它可能与 PTSD 可卡因使用者中观察到的负面临床结局有关。
