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创伤性生活事件与 PTSD 患者和非 PTSD 患者的酒精滥用/依赖之间有何关联?来自全国代表性样本的研究结果。

What is the association between traumatic life events and alcohol abuse/dependence in people with and without PTSD? Findings from a nationally representative sample.

机构信息

University of Regina, Regina, Saskatchewan, Canada.

出版信息

Depress Anxiety. 2011 Aug;28(8):632-8. doi: 10.1002/da.20852. Epub 2011 Jul 18.

DOI:10.1002/da.20852
PMID:21769995
Abstract

BACKGROUND

Approximately 60-90% of the general population will experience a traumatic event during their lifetime. However, relatively few will develop a trauma-related psychological disorder. Possible psychological sequelae of trauma include posttraumatic stress disorder (PTSD) and alcohol-use disorders (AUDs). While AUDs often occur in the context of PTSD, little is known about the degree to which AUDs are attributable to specific traumatic events. The purpose of the present investigation was to assess the degree to which specific traumatic events are predictive of AUDs in people with and without PTSD.

METHODS

The current sample was selected from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC; N = 34,160), a nationally representative sample of American adults. Multiple logistic regressions were performed to examine odds ratios of 27 traumatic events among individuals with and without PTSD in the prediction of AUD diagnoses.

RESULTS

Results indicated significant positive odds ratios among individuals meeting criteria for PTSD and having experienced a childhood trauma (OR = 1.40 [95% CI: 1.08-1.83], P<.01) or assaultive violence (OR = 1.41 [95% CI: 1.13-1.77], P<.01) for predicting AUDs. Also, among individuals without PTSD, childhood trauma (OR = 1.32 [95% CI: 1.23-1.41], P<.001), assaultive violence (OR = 1.42 [95% CI: 1.13-1.78], P<.001), unexpected death (OR = 1.19 [95% CI: 1.12-1.28], P<.001), and learning of trauma (OR = 1.22 [95% CI: 1.13-1.30], P<.001) positively predicted the presence of AUDs.

CONCLUSIONS

Results indicate significant positive relationships between traumatic events and AUDs, particularly among individuals without PTSD. Specific associations and theoretical implications will be discussed.

摘要

背景

大约 60-90%的普通人群在其一生中都会经历创伤性事件。然而,相对较少的人会发展出与创伤相关的心理障碍。创伤后的可能心理后果包括创伤后应激障碍(PTSD)和酒精使用障碍(AUD)。虽然 AUD 通常发生在 PTSD 的背景下,但对于 AUD 归因于特定创伤事件的程度知之甚少。本研究的目的是评估特定创伤事件在 PTSD 患者和非 PTSD 患者中预测 AUD 的程度。

方法

本研究样本选自全国酒精流行病学调查和相关条件(NESARC),这是一个具有全国代表性的美国成年人样本。进行了多项逻辑回归分析,以检查 PTSD 患者和非 PTSD 患者中 27 种创伤事件发生的可能性与 AUD 诊断之间的比值比。

结果

结果表明,在符合 PTSD 标准且经历过儿童期创伤(OR = 1.40 [95% CI:1.08-1.83],P<.01)或攻击暴力(OR = 1.41 [95% CI:1.13-1.77],P<.01)的个体中,有显著的正比值比预测 AUD。此外,在没有 PTSD 的个体中,儿童期创伤(OR = 1.32 [95% CI:1.23-1.41],P<.001)、攻击暴力(OR = 1.42 [95% CI:1.13-1.78],P<.001)、意外死亡(OR = 1.19 [95% CI:1.12-1.28],P<.001)和创伤学习(OR = 1.22 [95% CI:1.13-1.30],P<.001)也积极预测了 AUD 的存在。

结论

结果表明,创伤事件与 AUD 之间存在显著的正相关关系,尤其是在没有 PTSD 的个体中。将讨论具体的关联和理论意义。

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