a Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.
b U.S. Department of Veterans Affairs Connecticut Healthcare System , West Haven , CT , USA.
Am J Drug Alcohol Abuse. 2018;44(5):524-531. doi: 10.1080/00952990.2018.1454935. Epub 2018 Apr 11.
Posttraumatic stress disorder (PTSD) is prevalent among veterans who served post-9/11, and co-occurs with problem alcohol and substance use. Studies using ecological momentary assessment have examined the temporal association between time-varying PTSD symptoms and alcohol use. Results suggest individual differences in these associations.
We tested hypotheses that alcohol use measured by momentary assessment would be explained by acute increases in PTSD symptoms, and the PTSD-alcohol association would be moderated by trait impulsivity.
A sample of 28 male post-9/11-era veterans who reported past-month PTSD symptoms and risky alcohol use were enrolled. On a quasi-random schedule, participants completed three electronic assessments daily for 28 days measuring past 2-h PTSD symptoms, alcohol, and substance use. At baseline, trait impulsivity was measured by the Barratt Impulsiveness Scale. Past-month PTSD symptoms and alcohol use were measured. Using three-level hierarchical models, number of drinks recorded by momentary assessment was modeled as a function of change in PTSD symptoms since last assessment, controlling for lag-1 alcohol and substance use and other covariates. A cross-level interaction tested moderation of the within-time PTSD-alcohol association by impulsivity.
A total of 1,522 assessments were completed. A positive within-time association between PTSD symptom change and number of drinks was demonstrated. The association was significantly moderated by impulsivity.
Results provide preliminary support for a unique temporal relationship between acute PTSD symptom change and alcohol use among veterans with trait impulsiveness. If replicated in a clinical sample, results may have implications for a targeted momentary intervention.
创伤后应激障碍（PTSD）在 9/11 后服役的退伍军人中很常见，并且与问题酒精和物质使用共病。使用生态瞬时评估的研究已经检查了时间变化的 PTSD 症状与酒精使用之间的暂时关联。结果表明这些关联存在个体差异。
我们检验了以下假设：通过瞬时评估测量的酒精使用量可以用急性 PTSD 症状增加来解释，而 PTSD-酒精关联将受到特质冲动性的调节。
招募了 28 名报告过去一个月 PTSD 症状和危险饮酒的 9/11 后时代的男性退伍军人作为研究对象。根据准随机时间表，参与者每天完成三次电子评估，持续 28 天，评估过去 2 小时的 PTSD 症状、酒精和物质使用情况。在基线时，通过巴雷特冲动量表测量特质冲动性。测量过去一个月的 PTSD 症状和酒精使用情况。使用三级层次模型，将瞬时评估记录的饮酒量建模为自上次评估以来 PTSD 症状变化的函数，控制滞后 1 期的酒精和物质使用情况以及其他协变量。跨水平交互测试了冲动性对 PTSD-酒精关联的调节作用。
共完成了 1522 次评估。证明了 PTSD 症状变化与饮酒量之间存在正的时间内关联。该关联受到冲动性的显著调节。
结果初步支持了特质冲动性退伍军人中急性 PTSD 症状变化与酒精使用之间存在独特的时间关系。如果在临床样本中得到复制，结果可能对有针对性的瞬时干预具有重要意义。
