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探究创伤后应激障碍中的认知过程与饮酒冲动

Examining Cognitive Processes and Drinking Urge in PTSD.

作者信息

Read Jennifer P, Bachrach Rachel L, Wardell Jeffrey D, Coffey Scott F

机构信息

Department of Psychology, University at Buffalo, SUNY, USA.

Department of Psychiatry, Western Psychiatric Institute and Clinic, USA.

出版信息

Behav Res Ther. 2017 Mar;90:159-168. doi: 10.1016/j.brat.2016.12.014. Epub 2016 Dec 24.

Abstract

Despite their centrality to learning theories, strikingly little attention has been paid to the role of cognitions in efforts to understand associations between posttraumatic stress disorder (PTSD) and alcohol drinking. In the present study, we sought to examine information processing pathways for trauma and alcohol information, and the effects of posttraumatic stress and trauma cue exposure on these pathways. Participants were college students (N = 232; 49% female; M = 19.56,SD = 1.44) categorized into three diagnostic groups based on current PTSD status determined by structured clinical interview. These students then were exposed to a personalized trauma or neutral cue script, followed by a Stroop task modified to include trauma, alcohol, and contrast words. Indices of mood and urge to drink alcohol were administered throughout the task. Findings revealed that those with PTSD who were exposed to the personalized trauma cue showed a general response slowing across all stimuli types on the Stroop task. Intriguingly, this slowing effect was significantly associated with urge to drink alcohol for only those PTSD participants who were exposed to the trauma cues. In contrast, we did not find support for the hypothesis that trauma cues would lead to attention bias to trauma and alcohol specific Stroop stimuli among participants with PTSD, nor did slower RT for specific word types predict unique variance in urge to drink alcohol. Findings suggest that individual (PTSD) and environmental (cue) circumstances may work conjointly to precipitate changes in cognitive processing - changes that may have implications for drinking motivation. Given the importance of cognition in the etiology of both PTSD and drinking, this is a mechanism that warrants further investigation.

摘要

尽管认知在学习理论中处于核心地位,但令人惊讶的是,在理解创伤后应激障碍(PTSD)与饮酒之间的关联时,人们对认知的作用关注甚少。在本研究中,我们试图探究创伤和酒精信息的信息处理路径,以及创伤后应激和创伤线索暴露对这些路径的影响。参与者为大学生(N = 232;49%为女性;M = 19.56,SD = 1.44),根据结构化临床访谈确定的当前PTSD状态分为三个诊断组。这些学生随后接触个性化的创伤或中性线索脚本,接着进行一项经过修改的斯特鲁普任务,其中包括创伤、酒精和对比词。在整个任务过程中测量情绪和饮酒冲动指标。研究结果显示,接触个性化创伤线索的PTSD患者在斯特鲁普任务中对所有刺激类型的反应普遍变慢。有趣的是,这种变慢效应仅在接触创伤线索的PTSD参与者中与饮酒冲动显著相关。相比之下,我们没有找到支持以下假设的证据:创伤线索会导致PTSD患者对创伤和酒精特定的斯特鲁普刺激产生注意偏向,特定单词类型的反应时间变慢也不能预测饮酒冲动的独特差异。研究结果表明,个体(PTSD)和环境(线索)情况可能共同作用,促使认知加工发生变化——这些变化可能对饮酒动机产生影响。鉴于认知在PTSD和饮酒病因中的重要性,这是一个值得进一步研究的机制。

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