Ruglass Lesia M, Shevorykin Alina, Brezing Christina, Hu Mei-Chen, Hien Denise A
Department of Psychology, The City College of New York, CUNY, 160 Convent Avenue, NAC Building, Rm 7/120, New York, NY 10031, United States.
Department of Psychology, Pace University, 861 Bedford Road, Pleasantville, NY, United States.
J Subst Abuse Treat. 2017 Sep;80:45-51. doi: 10.1016/j.jsat.2017.06.007. Epub 2017 Jun 28.
While the detrimental effects of concurrent substance use disorders (SUDs) are now being well documented, very few studies have examined this comorbidity among women with posttraumatic stress disorder (PTSD). Data for these analyses were derived from the "Women and Trauma" study conducted within the National Drug Abuse Treatment Clinical Trials Network. Women with full or subthreshold PTSD and co-occurring cannabis use disorder (CUD) and cocaine use disorder (COD; N=99) were compared to their counterparts with co-occurring CUD only (N=26) and co-occurring COD only (N=161) on rates of trauma exposure, psychiatric disorders, psychosocial problems, and other substance use utilizing a set of multivariate logistic regressions. In models adjusted for age and race/ethnicity, women with PTSD and COD only were significantly older than their counterparts with CUD only and concurrent CUD+COD. Relative to those with CUD only, women with concurrent CUD+COD had higher odds of adult sexual assault. Relative to those with COD only, women with concurrent CUD+COD had higher odds of alcohol use disorder in the past 12months. Finally, relative to those with CUD only, women with COD only had higher odds of ever being arrested/convicted and adult sexual assault. The higher rates of adult sexual assault and alcohol use disorder among those with concurrent CUD+COD suggest the need for trauma-informed approaches that can respond to the needs of this dually-diagnosed population. Moreover, the causal link between repeated traumatic stress exposure and polysubstance use requires further examination.
虽然并发物质使用障碍(SUDs)的有害影响如今已得到充分记录,但很少有研究考察创伤后应激障碍(PTSD)女性中的这种共病情况。这些分析的数据来自于国家药物滥用治疗临床试验网络开展的“女性与创伤”研究。利用一组多变量逻辑回归,将患有完全或亚阈值PTSD且并发大麻使用障碍(CUD)和可卡因使用障碍(COD;N = 99)的女性,与仅并发CUD(N = 26)和仅并发COD(N = 161)的女性在创伤暴露率、精神障碍、心理社会问题及其他物质使用方面进行了比较。在根据年龄和种族/族裔进行调整的模型中,仅患有PTSD和COD的女性显著比仅患有CUD以及同时患有CUD + COD的女性年龄更大。与仅患有CUD的女性相比,同时患有CUD + COD的女性遭受成人性侵犯的几率更高。与仅患有COD的女性相比,同时患有CUD + COD的女性在过去12个月中患酒精使用障碍的几率更高。最后,与仅患有CUD的女性相比,仅患有COD的女性曾被捕/被定罪以及遭受成人性侵犯的几率更高。同时患有CUD + COD的女性中较高的成人性侵犯率和酒精使用障碍率表明,需要采用能够满足这一双重诊断人群需求的创伤知情方法。此外,反复创伤应激暴露与多种物质使用之间的因果关系需要进一步研究。