University of Houston, Department of Psychology, Houston, TX, USA.
Houston Fire Department, Houston, TX, USA.
Psychiatry Res. 2017 May;251:69-75. doi: 10.1016/j.psychres.2017.02.011. Epub 2017 Feb 6.
Depression, posttraumatic stress, and alcohol use are highly prevalent among firefighters. However, no study has evaluated the interactive effects of depression and posttraumatic stress with regard to alcohol use among firefighters. The current study examined main and interactive effects of depression and posttraumatic stress in terms of alcohol dependence symptoms, positive alcohol dependence screen, and drinks per occasion. Participants included 2707 male urban firefighters. There was a main effect of posttraumatic stress in relation to all alcohol-related outcomes and a main effect of depression only for alcohol dependence symptoms. There was a significant interaction of depression and posttraumatic stress with regard to symptoms of alcohol dependence, positive screen for alcohol dependence, and number of drinks per occasion. Interactions were evident above main effects and covariates (age, presence of a spouse/partner, tenure in the fire department, history of active duty in the U.S. armed forces, and racial/ethnic minority status). Overall, heightened depression was positively associated with alcohol-related outcomes for those with lower but not higher levels of posttraumatic stress in all models. Posttraumatic stress and depression may pose unique interactive risks for alcohol dependence in urban male firefighters. Implications for clinical intervention in firefighters are discussed.
抑郁、创伤后应激和饮酒在消防员中非常普遍。然而，尚无研究评估抑郁和创伤后应激对消防员饮酒的相互影响。本研究考察了抑郁和创伤后应激对酒精依赖症状、阳性酒精依赖筛查和每次饮酒量的主要和交互作用。参与者包括 2707 名男性城市消防员。创伤后应激与所有与酒精相关的结果均存在主要作用，而抑郁仅与酒精依赖症状存在主要作用。抑郁和创伤后应激与酒精依赖症状、阳性酒精依赖筛查和每次饮酒量之间存在显著的交互作用。这些交互作用在主要作用和协变量（年龄、是否有配偶/伴侣、在消防部门的任期、在美国武装部队现役史和种族/民族少数群体地位）上均有体现。在所有模型中，对于创伤后应激水平较低但不高的个体，抑郁程度的升高与酒精相关结果呈正相关。在城市男性消防员中，创伤后应激和抑郁可能对酒精依赖构成独特的交互风险。讨论了对消防员进行临床干预的意义。
