Contractor Ateka A, Presseau Candice, Capone Christy, Reddy Madhavi K, Shea M Tracie
Department of Psychology, University of Toledo, 2801 West Bancroft Street, Toledo, OH 43606-3390, United States; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box Box G-BH, Providence, RI 02912, United States.
Department of Veteran Affairs, Providence VA Medical Center, 830 Chalkstone Avenue, Providence, RI 02908, United States; Department of Education and Human Services, College of Education, Lehigh University, 111 Research Drive, Bethlehem, PA 18015, United States.
Addict Behav. 2016 Apr;55:5-14. doi: 10.1016/j.addbeh.2015.12.010. Epub 2015 Dec 17.
Posttraumatic Stress Disorder (PTSD) is frequently comorbid with alcohol use disorders (AUD; Calabrese et al., 2011; McFall, Mackay, & Donovan, 1992). Among several explanations for this comorbidity, the most empirically supported is the self-medication theory which postulates that substances are used to medicate PTSD-related distress (Keane & Wolfe, 1990; Khantzian, 1985; Stewart, 1996). The current study examines the effects of trauma-related distress on alcohol use (total drinking days, drinks per drinking day, heavy drinking days) in a sample of 127 trauma-exposed Veterans following deployment to Iraq or Afghanistan. The dysphoria symptoms of PTSD were used as an indicator of distress, and examined as a moderator in the relationship between intrusion symptoms of PTSD and alcohol use. The proposed moderation model was tested using cross-sectional data from the first month following return from deployment, and at 6 months and at 12 months post-deployment. Results showed that dysphoria symptoms significantly moderated relations between intrusions and total drinking days and heavy drinking days at one month post-deployment; however, a significant pattern was not demonstrated at 6 months and 12 months. Further, dysphoria did not moderate the relation between intrusion symptoms and drinks per drinking day at the three time points. Theoretical and clinical implications are subsequently discussed.
创伤后应激障碍(PTSD)常与酒精使用障碍(AUD;卡拉布雷斯等人,2011年;麦克福尔、麦凯和多诺万,1992年)共病。对于这种共病现象有多种解释,其中得到最多实证支持的是自我用药理论,该理论假定使用物质来缓解与PTSD相关的痛苦(基恩和沃尔夫,1990年;坎齐安,1985年;斯图尔特,1996年)。本研究考察了127名曾接触创伤的退伍军人在被部署到伊拉克或阿富汗后,创伤相关痛苦对酒精使用(饮酒总天数、每日饮酒量、重度饮酒天数)的影响。PTSD的烦躁不安症状被用作痛苦的指标,并作为PTSD侵入性症状与酒精使用之间关系的调节变量进行检验。使用从部署返回后的第一个月、部署后6个月和12个月的横断面数据对所提出的调节模型进行了测试。结果显示,在部署后一个月,烦躁不安症状显著调节了侵入性症状与饮酒总天数和重度饮酒天数之间的关系;然而,在6个月和12个月时未显示出显著模式。此外,在这三个时间点,烦躁不安均未调节侵入性症状与每日饮酒量之间的关系。随后讨论了理论和临床意义。