Naifeh James A, Tull Matthew T, Gratz Kim L
Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
Cognit Ther Res. 2012 Jun 1;36(3):247-257. doi: 10.1007/s10608-010-9337-8.
High rates of co-occurring posttraumatic stress disorder (PTSD) have been found among patients receiving treatment for substance use disorders (SUD), and there is evidence that this particular co-occurrence is associated with negative SUD treatment outcomes. Thus, there is utility in establishing the role of psychological vulnerabilities related to PTSD within SUD populations, with the goal of ultimately informing targeted interventions and improving clinical outcomes. Anxiety sensitivity (AS) and emotional avoidance (EA) may be two important factors in this regard, as both have been found to demonstrate associations with posttraumatic stress in other clinical and nonclinical populations. To expand upon this literature, the current study examined the associations between AS and EA and PTSD symptom severity in a sample of traumatic event-exposed crack/cocaine dependent patients in residential SUD treatment (n = 62), as well as the extent to which EA mediated the relation between AS and PTSD symptom severity. As hypothesized, AS and EA were associated with PTSD symptom severity above and beyond the effects of gender and non-specific anxiety symptoms. However, the hypothesis that EA would mediate the relation between AS and PTSD symptom severity was only partially supported. Implications of these findings for understanding and treating co-occurring SUD-PTSD are discussed.
在接受物质使用障碍(SUD)治疗的患者中,已发现创伤后应激障碍(PTSD)的并发率很高,并且有证据表明这种特定的并发情况与SUD治疗的负面结果相关。因此,确定PTSD相关的心理脆弱性在SUD人群中的作用具有实用价值,其目标是最终为有针对性的干预措施提供信息并改善临床结果。焦虑敏感性(AS)和情绪回避(EA)可能是这方面的两个重要因素,因为在其他临床和非临床人群中,两者均已被发现与创伤后应激存在关联。为了扩展这方面的文献,本研究在接受住院SUD治疗的有创伤事件暴露史的快克/可卡因依赖患者样本(n = 62)中,考察了AS和EA与PTSD症状严重程度之间的关联,以及EA在多大程度上介导了AS与PTSD症状严重程度之间的关系。正如所假设的那样,AS和EA与PTSD症状严重程度相关,且超出了性别和非特异性焦虑症状的影响。然而,关于EA会介导AS与PTSD症状严重程度之间关系的假设仅得到部分支持。本文讨论了这些发现对于理解和治疗并发的SUD - PTSD的意义。