Weiss Nicole H, Connolly Kevin M, Gratz Kim L, Tull Matthew T
a Yale University School of Medicine , New Haven , Connecticut , USA.
b University of Mississippi Medical Center , Jackson , Mississippi , USA.
J Dual Diagn. 2017 Apr-Jun;13(2):109-118. doi: 10.1080/15504263.2017.1293310. Epub 2017 Feb 8.
Individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorder report heightened levels of numerous risky and health-compromising behaviors, including aggressive behaviors. Given evidence that aggressive behavior is associated with negative substance use disorder treatment outcomes, research is needed to identify the factors that may account for the association between PTSD and aggressive behavior among patients with substance use disorder. Thus, the goal of this study was to examine the role of impulsivity dimensions (i.e., negative urgency, lack of premeditation, lack of perseverance, and sensation seeking) in the relations between probable PTSD status and both verbal and physical aggression.
Participants were 92 patients in residential substance use disorder treatment (75% male; 59% African American; M age = 40.25) who completed self-report questionnaires.
Patients with co-occurring PTSD-substance use disorder (vs. substance use disorder alone) reported significantly greater verbal and physical aggression as well as higher levels of negative urgency and lack of premeditation. Lack of premeditation and lack of perseverance were significantly positively associated with verbal aggression, whereas negative urgency, lack of premeditation, and lack of perseverance were significantly positively associated with physical aggression. The indirect relation of probable PTSD status to physical aggression through negative urgency was significant.
Results highlight the potential utility of incorporating skills focused on controlling impulsive behaviors in the context of negative emotional arousal in interventions for physical aggression among patients with co-occurring PTSD-substance use disorder.
患有创伤后应激障碍（PTSD）和物质使用障碍的个体报告了大量高风险和危害健康行为的增加，包括攻击行为。鉴于有证据表明攻击行为与物质使用障碍的负面治疗结果相关，需要开展研究以确定可能解释物质使用障碍患者中PTSD与攻击行为之间关联的因素。因此，本研究的目的是检验冲动性维度（即消极紧迫性、缺乏预谋、缺乏毅力和寻求刺激）在可能的PTSD状态与言语攻击和身体攻击之间关系中的作用。
参与者为92名接受住院物质使用障碍治疗的患者（75%为男性；59%为非裔美国人；平均年龄=40.25岁），他们完成了自我报告问卷。
同时患有PTSD-物质使用障碍的患者（与仅患有物质使用障碍的患者相比）报告的言语攻击和身体攻击明显更多，消极紧迫性和缺乏预谋的水平也更高。缺乏预谋和缺乏毅力与言语攻击显著正相关，而消极紧迫性、缺乏预谋和缺乏毅力与身体攻击显著正相关。可能的PTSD状态通过消极紧迫性与身体攻击的间接关系显著。
结果强调了在针对同时患有PTSD-物质使用障碍患者的身体攻击干预中，纳入侧重于在消极情绪唤醒背景下控制冲动行为技能的潜在效用。
