a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA.
c Department of Psychiatry and Behavioral Science , University of North Dakota School of Medicine & Health Sciences , Fargo , ND , USA.
Am J Drug Alcohol Abuse. 2018;44(5):532-542. doi: 10.1080/00952990.2018.1430149. Epub 2018 Feb 14.
Accumulating evidence indicates a link between post-traumatic stress disorder (PTSD) and cannabis use and suggests that this link may vary as a function of the PTSD symptom cluster type. Consistent with negative reinforcement models of substance use, individuals with elevated Cluster D (Hyperarousal) symptoms may be more likely to use cannabis in response to elevated state anxiety and experience decreases in state anxiety after using cannabis.
We aimed to test hypotheses that the interaction of Cluster D and state anxiety would be related to subsequent cannabis use and that those with elevated Cluster D symptoms who used cannabis would report the greatest decreases in state anxiety. To test the specificity, we tested whether Clusters B (re-experiencing) and C (avoidance) showed similar relationships.
The present study used ecological momentary assessment to examine cannabis use among 87 cannabis-using individuals with PTSD symptoms (64.4% male, 56.3% non-Hispanic Caucasian). State anxiety and cannabis use were assessed over the two-week period via signal contingent (six random prompts per day), interval contingent (each bedtime), and event contingent (cannabis use episodes) assessments.
Consistent with negative reinforcement models, participants with clinically significant Cluster D symptoms with elevated state anxiety had a greater likelihood of subsequent cannabis use and cannabis use resulted in less subsequent anxiety. The negative reinforcement hypothesis was only partially supported for those with Cluster B and C symptoms.
The results suggest that negative reinforcement models may be especially relevant to understanding cannabis use among those with clinically elevated Cluster D symptoms.
越来越多的证据表明创伤后应激障碍（PTSD）与大麻使用之间存在关联，并表明这种关联可能因 PTSD 症状簇类型而异。与物质使用的负强化模型一致，具有升高的 D 簇（过度警觉）症状的个体可能更有可能在状态焦虑升高时使用大麻，并在使用大麻后体验到状态焦虑降低。
我们旨在检验以下假设：D 簇和状态焦虑的相互作用与随后的大麻使用有关，并且那些具有升高的 D 簇症状且使用大麻的人报告的状态焦虑降低最大。为了测试特异性，我们测试了 B 簇（重新体验）和 C 簇（回避）是否表现出类似的关系。
本研究使用生态瞬时评估来检查 PTSD 症状（64.4%男性，56.3%非西班牙裔白种人）的 87 名大麻使用个体中的大麻使用情况。通过信号条件（每天六次随机提示）、间隔条件（每次睡前）和事件条件（大麻使用发作）评估在两周内评估状态焦虑和大麻使用。
与负强化模型一致，具有临床显著 D 簇症状且状态焦虑升高的参与者随后使用大麻的可能性更大，并且大麻使用导致随后的焦虑减轻。对于具有 B 簇和 C 簇症状的个体，负强化假设仅得到部分支持。
这些结果表明，负强化模型可能与理解具有临床升高的 D 簇症状的个体中大麻使用特别相关。
