创伤后应激症状与酒精问题：自我药疗还是特质易感性？
Posttraumatic stress symptoms and alcohol problems: self-medication or trait vulnerability?
作者信息
Read Jennifer P, Merrill Jennifer E, Griffin Melissa J, Bachrach Rachel L, Khan Saba N
机构信息
Department of Psychology, University at Buffalo, State University of New York, Buffalo, New York.
出版信息
Am J Addict. 2014 Mar-Apr;23(2):108-16. doi: 10.1111/j.1521-0391.2013.12075.x. Epub 2013 Jun 10.
BACKGROUND AND OBJECTIVES
Posttraumatic stress symptoms (PTSD) and problem alcohol use (ALC) commonly co-occur, but the nature of this co-occurrence is unclear. Self-medication explanations have been forwarded, yet traits such as tendency toward negative emotionality and behavioral disconstraint also have been implicated. In this study we test three competing models (Self-Medication, Trait Vulnerability, Combined Dual Pathway) of PTSD-ALC prospectively in a college sample.
METHOD
Participants (N=659; 73% female, M age=18) provided data at college matriculation (Time 1) and 1 year later (Time 2).
RESULTS
Structural equation models showed disconstraint to meditate the path from PTSD symptoms to alcohol problems, supporting a trait vulnerability conceptualization. Findings regarding negative emotionality and self-medication were more mixed. Negative emotionality played a stronger role in cross-sectional than in prospective analyses, suggesting the importance of temporal proximity.
CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE
Self-regulation skills may be an important focus for clinicians treating PTSD symptoms and alcohol misuse disorders concurrently.
背景与目的
创伤后应激症状（PTSD）与酒精使用问题（ALC）常常同时出现，但这种共现的本质尚不清楚。自我用药的解释已被提出，然而诸如消极情绪倾向和行为放纵等特质也与之有关。在本研究中，我们前瞻性地在一个大学样本中检验了PTSD-ALC的三种相互竞争的模型（自我用药、特质易感性、联合双路径）。
方法
参与者（N = 659；73%为女性，平均年龄 = 18岁）在大学入学时（时间1）和1年后（时间2）提供数据。
结果
结构方程模型显示放纵在介导从PTSD症状到酒精问题的路径中起作用，支持特质易感性的概念化。关于消极情绪和自我用药的研究结果更为复杂。消极情绪在横断面分析中比在前瞻性分析中发挥的作用更强，表明时间接近性的重要性。
结论与科学意义
自我调节技能可能是临床医生同时治疗PTSD症状和酒精滥用障碍的一个重要关注点。
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