Afzali Mohammad H, Sunderland Matthew, Batterham Philip J, Carragher Natacha, Calear Alison, Slade Tim
NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, 2052, Australia.
National Institute for Mental Health Research, Australian National University, Canberra, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2017 Mar;52(3):329-339. doi: 10.1007/s00127-016-1331-3. Epub 2016 Dec 24.
The high prevalence of alcohol use disorder among individuals with a history of trauma and posttraumatic stress disorder is well documented. The current study applied network analysis to map the structure of symptom associations between these disorders.
Data come from a community sample of 449 Australian adults with a history of trauma and alcohol consumption during the last 12 months. Data analysis consisted of the construction of the comorbidity network of PTSD/AUD symptoms, identification of the bridging symptoms, computation of the centrality measures, and evaluation of the robustness of the results.
Results highlighted two main symptom clusters, corresponding to two disorders, and that only nine edges connected the two clusters. Bridging symptoms connecting the two clusters were: alcohol use in dangerous situations, physical or mental health problems as a result of alcohol use, loss of interest or reduced social activities, and reckless/self-destructive behaviour.
Identification of both central symptoms, because of their key role in the constellation and strong associations with majority of symptoms, and bridge symptoms, because of their mediating role between two disorders, has some implications in terms of self-medication and risk-taking/self-regulation theories of comorbidity and provides a number of clinical implications, which warrants further exploration within clinical samples.
有创伤史和创伤后应激障碍的个体中酒精使用障碍的高患病率已有充分记录。当前研究应用网络分析来描绘这些障碍之间症状关联的结构。
数据来自449名有创伤史且在过去12个月内饮酒的澳大利亚成年人的社区样本。数据分析包括创伤后应激障碍/酒精使用障碍症状共病网络的构建、桥接症状的识别、中心性度量的计算以及结果稳健性的评估。
结果突出了两个主要症状簇,对应两种障碍,且仅有九条边连接这两个簇。连接两个簇的桥接症状为:在危险情境中饮酒、因饮酒导致的身心健康问题、兴趣丧失或社交活动减少以及鲁莽/自我毁灭行为。
识别核心症状(因其在症状群中的关键作用以及与大多数症状的强关联)和桥接症状(因其在两种障碍之间的中介作用),对于共病的自我用药和冒险/自我调节理论具有一定意义,并提供了一些临床启示,这值得在临床样本中进一步探索。