Norman Sonya B, Schmied Emily, Larson Gerald E
National Center for PTSD, Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, California, School of Medicine, University of California, San Diego, San Diego, California.
Naval Health Research Center, San Diego, California.
J Stud Alcohol Drugs. 2014 Jul;75(4):557-66. doi: 10.15288/jsad.2014.75.557.
The goals of the present study were to (a) examine change in rates of problem alcohol/substance use among a sample of veterans between their last year of military service and their first year following separation, (b) identify predictors of continued problem use in the first year after separation, and (c) evaluate the hypothesis that avoidant coping, posttraumatic stress disorder (PTSD) symptoms, and chronic stress place individuals at particularly high risk for continued problem use.
Participants (N = 1,599) completed self-report measures before and during the year following separation. Participants who endorsed either having used more than intended or wanting or needing to cut down during the past year were considered to have problem use.
Of 742 participants reporting problem substance use at baseline, 42% reported continued problem substance use at follow-up ("persistors"). Persistors reported more trouble adjusting to civilian life, had a greater likelihood of driving while intoxicated, and had a greater likelihood of aggression. Multivariate analyses showed that avoidant coping score at baseline and higher PTSD symptom score and greater sensation seeking at follow up predicted continued problem use.
Understanding risk factors for continued problem use is a prerequisite for targeted prevention of chronic problems and associated negative life consequences.
本研究的目标是:(a)在一组退伍军人样本中,考察其服役最后一年至退役后第一年期间问题饮酒/物质使用发生率的变化;(b)确定退役后第一年持续存在问题使用的预测因素;(c)评估以下假设,即回避型应对、创伤后应激障碍(PTSD)症状和慢性应激会使个体面临持续问题使用的特别高风险。
参与者(N = 1599)在退役后的当年之前及期间完成了自我报告测量。在过去一年中认可使用量超过预期或想要或需要减少使用量的参与者被视为存在问题使用。
在基线时报告存在问题物质使用的742名参与者中,42%在随访时报告持续存在问题物质使用(“持续使用者”)。持续使用者报告在适应平民生活方面有更多困难,酒后驾车的可能性更大,且有更大的攻击可能性。多变量分析表明,基线时的回避型应对得分、随访时较高的PTSD症状得分以及较高的寻求刺激得分可预测持续存在问题使用。
了解持续问题使用的风险因素是针对性预防慢性问题及相关负面生活后果的先决条件。