The Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park Division (152), 795 Willow Road, Menlo Park, CA 94025, USA.
Psychol Addict Behav. 2011 Sep;25(3):485-91. doi: 10.1037/a0021945.
The present investigation prospectively evaluated whether treatment changes in PTSD symptom severity, among military Veterans in residential PTSD treatment, were related to cannabis use 4 months after discharge from residential rehabilitation. The sample was comprised of 432 male military Veteran patients (Mage = 51.06 years, SD = 4.17), who had a primary diagnosis of PTSD and were admitted to a VA residential rehabilitation program for PTSD. Results demonstrated that lower levels of change in PCL-M scores between treatment intake and discharge were significantly predictive of greater frequency of cannabis use at 4-month follow-up (p < .05), even after accounting for the effects of length of treatment stay and frequency of cannabis use during the 2 months before treatment intake. Furthermore, post hoc analyses revealed that less change in PTSD avoidance/numbing and hyperarousal symptom severity during treatment was significantly predictive of a greater frequency of cannabis use at 4-month follow-up, after controlling for relevant covariates. Notably, these effects were specific to cannabis and were not found for the other substances examined among this sample, including alcohol and opiates. Implications of the findings are discussed with regard to the extant literature and future directions.
本研究前瞻性地评估了 PTSD 症状严重程度的治疗变化是否与退伍军人从住宅康复中出院后 4 个月的大麻使用有关。该样本包括 432 名男性退伍军人患者(Mage = 51.06 岁,SD = 4.17),他们有 PTSD 的主要诊断,并被收入退伍军人事务部的 PTSD 住宅康复计划。结果表明,治疗开始时和出院时 PCL-M 评分变化较小与出院后 4 个月大麻使用频率较高显著相关(p <.05),即使在考虑了治疗时间长度和治疗前 2 个月大麻使用频率的影响后也是如此。此外,事后分析显示,在治疗期间 PTSD 回避/麻木和过度警觉症状严重程度的变化较小与出院后 4 个月大麻使用频率较高显著相关,在控制了相关协变量后也是如此。值得注意的是,这些影响是针对大麻的,而在该样本中检查的其他物质(包括酒精和阿片类药物)中没有发现这些影响。讨论了这些发现对现有文献和未来方向的意义。